Rashes that look like ringworm but aren’t – What are they?

Let’s take a detailed dive into this.

Introduction

The symptoms of ringworm differ when it comes to people. These symptoms are similar to other health or skin conditions similar to ringworm. If these rashes are not signs of ringworm, then what else could they be?

This article discusses why you might have rashes that look like ringworm but not actually ringworm. Let us consider what ringworm is before delving into other related conditions.

What is a ringworm infection?

Ringworm is a fungal infection of the skin. Other names commonly used are dermatophytosis, dermatophyte infection, or tinea. Fungus, not a worm, causes ringworm. 

Thus, ringworm is a misnomer. The lesion caused by this infection appears worm-like, hence the name ringworm. 

Ringworm infection can occur in both humans and animals. The infection initially appears as red patches on affected areas of the skin, and later may spread to other parts of the body. It may affect the scalp, feet, nails, groin, beard, or other areas.

What are the symptoms of a ringworm infection?

There are many symptoms of ringworm, and these may vary depending on the area where you are infected. In the case of a skin infection, below are some of the symptoms you may experience.

• Red, itchy, or scaly patches, or raised areas of skin called plaques.
• patches that develop blisters or pustules
• patches that may be redder on the outside edges or resemble a ring
• patches with edges that are defined and raised

For the cases of nails infections

• The nails become thick
• Discolored
• With cracks

The symptoms above are called dermatophytic onychomycosis, or tinea unguium

For scalp infection

• The hair around the affected area may break or fall off
• Bald patches can also appear

What are the causes of ringworm?

Three different types of fungi cause ringworm. They are Trichophyton, Microsporum, and Epidermophyton. These fungi can live for prolonged periods as spores in the soil. 

Both humans and animals can get ringworm from direct contact with this soil. The infection can also spread through contact with the infected animals or humans. This infection is mostly spread among children and sharing items containing the fungus. 

Ringworms are called different names depending on where it affects the body. Here are some of the causes of ringworm

• Ringworm of the scalp (tinea capitis). This type usually starts as isolated scaling in the scalp that develops into itchy, scaly bald patches. It’s most common among children.
• Ringworm of the body (tinea corporis) mostly appears as patches with the characteristic round ring shape.
• Jock itch (tinea cruris). It refers to ringworm infection affecting areas around the groin, pubic region, inner thighs, and buttocks. It’s most common in men and adolescent boys.
• Athlete’s foot (tinea pedis) is the common name for ringworm infection of the foot. It is common in people who go barefoot in public places where the infection can spread, such as locker rooms, showers, and swimming pools.

What are the rashes that look like ringworm but aren’t ringworm?

Many rashes look like ringworm but are not ringworm. It is because these rashes have similarities with that of ringworm. Below are some rashes that look like ringworm but are not ringworm.

Eczema (Atopic dermatitis) can present with rashes that look like ringworm

Eczema is a skin condition that often first appears as an itchy red patch with symptoms such as dry skin, rough or scaly patches of skin, swelling, and crusting.

The symptoms are similar to that of ringworm. Bites from bugs, certain medications, or metal allergies usually trigger this type of skin condition.

Eczema has no known cure. However, you can manage the symptoms with over-the-counter medication, lifestyle changes, prescription topicals, and immunosuppressants.

Psoriasis may also have rashes looking like ringworm

It is a chronic condition that causes a rapid buildup of skin cells leading to scaling on the skin’s surface. The itchy red patches and scales associated with psoriasis are similar to the case of ringworm.

However, psoriasis is not a fungal infection. Symptoms include cracked skin, dry skin, itching, soreness, red patches, marked inflammation with thick silvery scales. 

Granuloma annulare

This disease is not caused by an infection, and the cause is unknown as it stands now. It is often not dangerous nor progressive and it’s self-limiting. 

Due to its nature of pink-red bumps and a ring of small colored skin, granular annulare can also look like ringworm and be mistaken for ringworm infection. 

Granuloma annulare is a mild skin condition characterized by small, raised bumps that form a ring with a normal or sunken center. 

The cause of granuloma annulare is unknown but can affect people of all ages. Vaccination, infections, insect or animal bites, and minor skin injuries may be a contributor to this disease.

Lyme disease

It is an infectious disease caused by the bacterium Borrelia burgdorferi. An infected black-legged or deer tick transmits the bacterium to humans through a bite. 

The tick is infected after feeding on infected deer, birds, or mice. The town of Old Lyme, Connecticut, in 1975, recorded the first case of Lyme disease. 

It’s the most common tick-borne illness in Europe and the United States. It comes with rashes that are circular in appearance and can be mistaken for ringworm. These rashes may look just like the rashes from a ringworm infection but they actually aren’t.

Other symptoms of this disease may include flu-like symptoms and a spreading rash that’s itchy or painful. This condition requires treatment as soon as possible. 

Pityriasis rosea

Also called a Christmas tree rash, pityriasis rosea is an oval-shaped skin patch that can appear on different parts of your body. It is a common rash that affects people of all ages, but it typically occurs between 10 and 35 years. 

It usually starts with a round or oval scaly patch on your chest, back, and abdomen. Due to its shape, the first patch can be mistaken for ringworm infection. 

The primary cause of pityriasis rosea is not yet determined. It is not contagious like ringworm and usually goes away on its own in 6-8 weeks.

Other conditions include vitiligo, lupus, erythema migrans, contact dermatitis, tinea versicolor 

The takeaway from this article

If you find a rash on your skin, do not be quick to conclude that it is ringworm infection. There are many other conditions just as was discussed earlier that may present with rashes that look like ringworm and may be mistaken for ringworm infection. 

See a dermatologist to get the correct diagnosis or see a qualified health personnel to check if it is really ringworm or something else. 

References 

Drago F, Ciccarese G, Parodi A. Pityriasis rosea and pityriasis rosea-like eruptions: How to distinguish them? JAAD Case Rep. 2018 Sep;4(8):800-801

Moriarty B, Hay R, Morris-Jones R. The diagnosis and management of tinea. BMJ. 2012;345:e4380

Patton SK, Phillips B. CE: Lyme Disease: Diagnosis, Treatment, and Prevention. Am J Nurs. 2018 Apr;118(4):38-45.

Rubin CB, Rosenbach M. Granuloma annulare: a retrospective series of 133 patients. Cutis. 2019 Feb;103(2):102-106Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995;8:240–59