Intended for healthcare professionals

Endgames Spot Diagnosis

An annular plaque on the hand

BMJ 2020; 370 doi: (Published 16 September 2020) Cite this as: BMJ 2020;370:m2209
  1. Fei Han, dermatologist1,
  2. Bo Guo, dermatologist2
  1. 1Department of Dermatology, Suqian First Hospital, Suqian City, Jiangsu Province, China
  2. 2Department of Dermatology, Tongxiang Dermatology Hospital, Tongxiang City, Zhejiang Province, China
  1. Correspondence to: F Han srhanfei{at}

A 41 year old man presented with a five month history of a painless, non-pruritic rash on his left hand (fig 1). Six months earlier he had received cryotherapy with liquid nitrogen—applied using a cotton wool bud—for a common wart in the same location. The day after cryotherapy, a painful, haemorrhagic blister occurred at the treatment site. The blister was drained, and over the next 20 days it dried and healed. Two weeks later a new lesion developed on the rim of …

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