Abstract
Annular configuration is conspicuous in the clinical manifestation of many skin diseases
and can be helpful for the diagnosis and differential diagnosis. Variations may include
arciform, ring-form, annular, circinate, serpiginous, gyrated, polycyclic, targeted
or figurate forms, in different colors, sizes, and numbers, with various textures
and surfaces. In infectious dermatoses, the annular reactions can be specific or nonspecific,
while the underlying mechanisms remain largely unknown. In the specific reactions
caused by direct invasion of the pathogens, the contest between the centrifugal outspread
of the infectious agents and the centripetal impedance of the host immune response
is supposed to determine the final conformation. Examples include erythema infectiosum,
orf, erythema multiforme, and pityriasis rosea of viral origin. Bacterial infections
that may display annular lesions include erythrasma, erythema (chronicum) migrans
of Lyme borreliosis, secondary syphilis, cutaneous tuberculosis, and leprosy. Superficial
mycosis, such as dermatophytosis, candida intertrigo, tinea imbricata, and subcutaneous
mycosis, such as chromoblastomycosis, and algae infection protothecosis, are characterized
by annular progression of the skin lesions. The creeping serpiginous extension is
an alarming sign for the diagnosis of cutaneous larva migrans. A better understanding
of the virulence and pathogenicity of the pathogens and the way and type of immune
response will help to clarify the pathogenesis.
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Published online: December 30, 2021
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