Differential Diagnosis for 71-year-old Female with Maculopapular Rash
- Single most likely diagnosis
- Drug rash (e.g., due to Eliquis): This is a common cause of maculopapular rash in elderly patients, especially when they are on medications like Eliquis. The lack of mucous membrane involvement and normal lab results also support this diagnosis.
- Other Likely diagnoses
- Viral exanthem: Many viral infections can cause a maculopapular rash, and the absence of mucous membrane involvement does not rule out this possibility. Normal CRP and ear labs do not strongly support a viral etiology but do not exclude it either.
- Allergic contact dermatitis: Although less likely given the widespread nature of the rash, allergic contact dermatitis could still be considered, especially if the patient has been exposed to new substances or products.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Septicemia or bacteremia: Non-blanching rash on palms could be indicative of a more serious infection, such as meningococcemia or other bacterial infections, which would require immediate attention.
- Vasculitis: Certain types of vasculitis, like leukocytoclastic vasculitis, can present with a maculopapular rash and non-blanching lesions, which could be life-threatening if not promptly diagnosed and treated.
- Rare diagnoses
- Erythema multiforme: Although rare, erythema multiforme can present with a maculopapular rash and target lesions, but it often involves mucous membranes, which are spared in this case.
- Sweet syndrome: This condition is characterized by a sudden onset of fever, leukocytosis, and tender, erythematous, well-demarcated papules and plaques, which could be considered in the differential diagnosis, although it is less likely given the patient's presentation and normal lab results.