Azole Antifungal-Induced Erythema Annulare Centrifugum in a Case of Extensive Tinea

A 52-year-old female with extensive tinea developed erythema annulare centrifugum (EAC), a hypersensitivity reaction, after using azole antifungals. The EAC manifested as nonpruritic, annular, erythematous plaques. Histopathology confirmed the diagnosis, showing parakeratosis and perivascular infiltrates. The condition improved after discontinuing azoles and administering oral prednisolone, but recurred with re-exposure to azoles. Switching to oral terbinafine and antihistamines without topical azoles led to improvement. This case highlighted the potential for azole antifungals to induce EAC, emphasizing the need for clinical suspicion and careful management in similar cases.