Differential Diagnosis for Excoriations on Legs with Unilateral Swelling and Pain
- Single most likely diagnosis:
- Cellulitis: This is a common condition characterized by skin infection, typically caused by bacteria such as Streptococcus or Staphylococcus. The presence of excoriations, unilateral swelling, and pain are consistent with cellulitis, especially if there is a history of trauma or skin breach.
- Other Likely diagnoses:
- Deep Vein Thrombosis (DVT): DVT can cause unilateral swelling and pain in the leg. Excoriations may be secondary to scratching due to itching from post-thrombotic syndrome or from a related condition.
- Eczema or Dermatitis: These conditions can cause excoriations due to itching. If severe, they can lead to secondary infections, which might cause swelling and pain.
- Insect bites or allergic reactions: Multiple insect bites or an allergic reaction could lead to excoriations and swelling, especially if the reaction is severe.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Necrotizing Fasciitis: Although rare, this is a life-threatening condition that requires immediate attention. It can present with severe pain, swelling, and skin changes, including excoriations, especially if the skin is compromised.
- Compartment Syndrome: This is another emergency condition that can cause severe pain, swelling, and sometimes skin changes due to increased pressure within the muscle compartments of the leg.
- Rare diagnoses:
- Lymphedema: A condition characterized by chronic swelling of the leg due to lymphatic system dysfunction. Excoriations might occur due to scratching or secondary infections.
- Panniculitis: Inflammation of the subcutaneous fat, which can cause swelling, pain, and skin changes, including excoriations, especially if there is an underlying systemic condition.
- Vasculitis: Inflammation of the blood vessels can lead to a variety of skin manifestations, including excoriations, swelling, and pain, depending on the vessels affected and the underlying cause.