Don’t put your foot in it

Certain conditions are often found in particular areas. We instinctively think of a tinea infection if we see an annular rash appearing to spread out from a toe web space. 

However, a more careful inspection reveals there is no scale associated with this rash and the toe web spaces are actually clear. This is granuloma annulare with a dermal papular edge rather than the scaly edge of tinea. 

Antifungals will obviously have no effect on this rash. 

It should be treated with diluted intralesional steroid into the advancing edge or it can be left to settle on its own. 

Other images of this case can be viewed at