Pruritic annular papules and plaques on the face and back

A 35-year-old previously healthy man presented with a 1-year history of multiple pruritic lesions on both his face and back. The lesions presented with crops of papules measuring 1 to 2 mm in diameter, grouped to form annular plaques, with central hyperpigmentation (Fig 1). Antifungal treatment, including oral terbinafine for 2 weeks and topical bifonazole for 1 month, was given in another hospital without any improvement. A skin biopsy specimen was obtained from the patient's face. The histopathologic examination revealed a heavy infiltrate of eosinophils and lymphocytes surrounding the hair follicles and sebaceous glands.

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