A 35 years old male came with a progressive plaque over buttock for the last 2 years.The plaque is annular in shape with scarring in centre. Most likely diagnosis is:
## **Core Concept**
The question describes a patient with a progressive, annular plaque on the buttock with central scarring. This clinical presentation suggests a dermatological condition characterized by an annular (ring-shaped) lesion with central healing or scarring.
## **Why the Correct Answer is Right**
The description provided matches the typical presentation of **discoid lupus erythematosus (DLE)**, a chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp but can also occur on the buttocks. The lesions are often annular or discoid and can leave behind scarring. DLE is a form of lupus that is limited to the skin and is known for its characteristic skin lesions.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Without the specific details of option A, we can't directly assess its accuracy, but given the description, conditions like tinea corporis (ringworm) could be considered. However, tinea corporis typically does not leave central scarring.
- **Option B:** Similarly, without specifics, if option B suggested another autoimmune or dermatological condition, it would need to be evaluated based on its typical presentation. Conditions like psoriasis or eczema might present with plaques but usually don't have the characteristic annular shape with central scarring.
- **Option C:** If option C suggested a different diagnosis, the same logic would apply; the condition would need to match the description given.
- **Option D:** Assuming option D is not the correct answer, if it suggested a condition like syphilis (which can present with annular lesions), it would still not typically present with the degree of scarring described.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **discoid lupus erythematosus (DLE)** lesions can be highly variable but often present as well-defined, coin-shaped (or discoid) patches that can become confluent. Central scarring and atrophy are hallmarks of DLE, distinguishing it from other annular dermatological conditions.
## **Correct Answer:** D. Discoid lupus erythematosus.