HOW TO TAKE THE POST-TEST: This Clinical Advisor CME activity consists of 3 articles. To obtain credit, you must also read Depigmentation on the chest and nail folds and Recent-onset hair loss in a high school student; the post-test will include questions related to all three articles.To obtain CME/CE credit, please click here after reading the articles to take the post-test on


A woman, aged 69 years, presented with a mildly pruritic rash on her buttocks and lower back that had appeared two weeks earlier. The woman, who had recently undergone a hip replacement, did not recall starting any new medication and had applied no topical medications to the affected area.

Examination of the skin revealed several oval-shaped plaques with a distinct erythematous rim and central clearing. In addition, a fine scale was present at the inner periphery. No other lesions were noted.

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A woman, aged 26 years, noticed a slowly enlarging and itchy rash on her right flank. She denied taking any new medications and had not treated the rash with topical medications. History was remarkable only for hypothyroidism controlled with levothyroxine.

The patient had spent time outdoors on the New Jersey shore a few weeks earlier. No fever, malaise or flulike symptoms were reported. Physical exam revealed a 5-cm annular, slightly indurated and scaling rash with central clearing. There was no associated tenderness or warmth.

What is the diagnosis?

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