Annular Scaly Plaques.

Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:// www.aafp.org/afp/apps. A 57-year-old woman presented with a largely asymptomatic rash on her feet that began six months earlier. She had infrequent mild pruritus but no other symptoms related to the rash. She had no systemic symptoms such as fever, chills, myalgias, or arthralgias. The rash did not improve after two months of treatment with terbinafine cream (Lamisil). Physical examination demonstrated wellcircumscribed, erythematous, annular plaques on the dorsa of her feet that were 3 to 4 cm in diameter (Figure 1). The plaques had no induration, but there was a trailing white scale. They were nontender to palpation, and the surrounding skin was unaffected. Findings from a potassium hydroxide preparation of the scale were negative.