Differential Diagnosis for Fine Macular Rash on the Dorsum of the Hand
- Single most likely diagnosis
- Contact dermatitis: This is a common condition that occurs when the skin comes into contact with an irritant or allergen, leading to a rash. The dorsum of the hand is a common site for contact dermatitis due to exposure to various substances.
- Other Likely diagnoses
- Eczema (atopic dermatitis): A chronic skin condition characterized by dry, itchy, and inflamed skin. The hands can be affected, especially in individuals with a history of atopic dermatitis.
- Psoriasis: An autoimmune condition that can cause a rash on various parts of the body, including the hands. The rash is often accompanied by scaling and thickening of the skin.
- Tinea manuum: A fungal infection of the hand, which can cause a macular rash on the dorsum of the hand.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lyme disease: A bacterial infection transmitted by tick bites, which can cause a distinctive rash (erythema migrans) on the skin. Although less common, it's crucial to consider Lyme disease due to its potential severity if left untreated.
- Rocky Mountain spotted fever: A bacterial infection transmitted by tick bites, which can cause a rash on the hands and feet. This condition can be life-threatening if not promptly treated.
- Rare diagnoses
- Pityriasis rosea: A rare skin condition characterized by a macular rash, often accompanied by a "herald patch" on the trunk. Although less common, it can affect the hands.
- Secondary syphilis: A bacterial infection that can cause a macular rash on various parts of the body, including the hands. This condition is relatively rare but important to consider due to its potential consequences if left untreated.