Enlarging annular plaques and patches

A white man, aged 63 years, was referred for evaluation of annular papulosquamous plaques and patches that first appeared on his arms and legs about one year earlier.

Multiple providers had diagnosed him with psoriasis, fungal infection, and "ringworm." Despite the application of triamcinolone 0.1% and clotrimazole/betamethasone (Lotrisone) creams, the lesions continued to grow. No night sweats, fever, myalgia, or cough ...