Annular erythema on the face

This is annular erythema on the face of a man in his 50s (fig 1). He presented with a six year history of an asymptomatic, well defined 12 cm diameter lesion that had been unresponsive to topical terbinafine. The patient had some loss of fine touch sensation and nociception, but peripheral nerves were not palpable or tender on examination. Histological examination revealed epithelioid granulomas without necrosis. Acid fast bacilli in skin smears and results from nested polymerase chain reaction and DNA sequencing confirmed Mycobacterium leprae. Borderline tuberculoid leprosy was diagnosed on the basis of clinical and laboratory findings.Differentials include subacute cutaneous lupus erythematosus, tinea faciei, erythema annulare centrifugum, mycosis fungoides, lupus vulgaris, and sarcoidosis. Recognising that these clinical features may be caused by leprosy may enable earlier diagnosis and treatment before disability occurs. The erythema improved after a few weeks of multidrug treatment for leprosy.bmj;379/nov16_2/e071187/F1F1f1Fig 1
Read Original Article: Annular erythema on the face »