O/E: 2.5 c.m. annular, scsaly plaque l. wrist. Borders are erythematous and indurated. No other similar lesions.
KOH scraping was negative.
Dx: Presumptive diagnosis is Majocci Granuloma.
Fungal culture taken.
Started on betamethasome disproprionate/clotrimazole cream b.i.d. for two weeks only.
Follow-up visit scheduled for two weeks.
Low threshold for biopsy if culture negative and if he is not doing well.
Switch to ketoconazole 2% cream; consider oral terbinafine.