Differential Diagnosis for Annular Palm Lesions and Hives
Single Most Likely Diagnosis
- Dyshidrotic Eczema (Pompholyx): This condition is characterized by the appearance of small, itchy blisters or vesicles on the palms, often in an annular pattern. It can be accompanied by hives in some cases, especially if there's an allergic component or a secondary infection.
Other Likely Diagnoses
- Contact Dermatitis: This is a type of skin inflammation caused by contact with irritants or allergens. It can present with annular lesions on the palms and may be accompanied by hives if the reaction is severe or widespread.
- Tinea Manuum: A fungal infection of the hand, which can cause annular lesions. While it doesn't typically cause hives, the discomfort and itching might lead to scratching, potentially causing hives or urticarial lesions in some cases.
- Psoriasis: Palmoplantar psoriasis can present with annular lesions and may be accompanied by hives in the context of a psoriatic eruption, especially if there's a systemic component.
Do Not Miss Diagnoses
- Erythema Multiforme: A skin condition characterized by target lesions, which can sometimes appear annular. It can be accompanied by hives and is often a reaction to an infection or medication. Missing this diagnosis could lead to significant morbidity.
- Urticarial Vasculitis: An inflammation of the blood vessels that can cause hives and skin lesions, including annular ones on the palms. It's crucial not to miss this diagnosis due to its potential for systemic involvement and complications.
Rare Diagnoses
- Granuloma Annulare: A benign skin condition that can cause annular lesions, though it's less common on the palms. It might not typically cause hives but could be considered in the differential for annular palm lesions.
- Necrolytic Migratory Erythema: A rare skin condition associated with glucagonoma syndrome, characterized by necrolytic migratory erythema that can appear as annular lesions. While extremely rare, it's an important consideration due to its association with an underlying malignancy.