What causes pruritus (itching) of the soles and palms?

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Differential Diagnosis for Sole and Palm Itching

  • Single most likely diagnosis
    • Dry skin (xerosis): This is a common condition that can cause itching on the soles and palms due to lack of moisture, especially in dry environments or during winter months.
  • Other Likely diagnoses
    • Eczema (atopic dermatitis): A chronic skin condition characterized by itchy, inflamed skin, which can affect the palms and soles.
    • Psoriasis: An autoimmune condition that can cause red, scaly, and itchy patches on the skin, including the palms and soles.
    • Contact dermatitis: A type of skin inflammation caused by contact with irritants or allergens, which can lead to itching on the palms and soles.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Liver disease (e.g., primary biliary cirrhosis): Severe itching can be a symptom of liver disease, and it's essential to rule out this possibility due to its potential severity.
    • Thyroid disorders (e.g., hyperthyroidism): Some thyroid conditions can cause itching, and missing this diagnosis could lead to delayed treatment and complications.
    • Lymphoma: Certain types of lymphoma can cause itching, and early detection is crucial for effective treatment.
  • Rare diagnoses
    • Aquagenic pruritus: A rare condition characterized by itching after exposure to water, which can affect the palms and soles.
    • Polycythemia vera: A rare blood disorder that can cause itching, especially after exposure to water.
    • Cholestasis: A condition characterized by reduced bile flow, which can cause severe itching, including on the palms and soles.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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