ReginaldoCastro

Internal Medicine

Hypochromic Spots

Clinical Summary:
Circular, multiple hypochromic spots, of varying size and centrifugal growth, asymptomatic on the back of the left foot for 2 weeks. Female patient, 37 years old, domestic worker in a rural area.

Update 1

Differential Diagnosis:

• Tinea corporis
• Pityriasis versicolor
• Early indeterminate leprosy
• Granuloma annulare

Diagnosis:
Clinical findings were most consistent with tinea corporis (dermatophytosis).

Management:
The patient was treated with topical antifungal therapy (terbinafine 1% cream) applied twice daily for 2–4 weeks, with clinical improvement expected.

Discussion:
Tinea corporis typically presents as annular lesions with centrifugal expansion and central clearing. Although pruritus is common, asymptomatic cases may occur. Rural exposure may increase the risk of dermatophyte infection. Evaluation of sensory changes is essential to exclude early leprosy in endemic regions.

Diagnosis Added:
Tinea Corporis

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