Differential Diagnosis for Bilateral Erythema Limited to Toes with Small Fluid Bisters
- Single most likely diagnosis
- Erythema multiforme: This condition is characterized by the sudden onset of symmetric skin lesions, often on the extremities, including the toes. The presence of small fluid blisters (vesicles) along with erythema makes it a strong candidate for the single most likely diagnosis.
- Other Likely diagnoses
- Contact dermatitis: This is a type of inflammation of the skin that occurs when the skin comes into contact with an irritant or allergen. It could present with erythema and blisters if the irritant is strong enough, such as certain chemicals or plants.
- Dyshidrotic eczema: Also known as pompholyx, this condition is characterized by small, itchy blisters on the hands or feet, which could fit the description provided.
- Pustular psoriasis: Although less common on the toes, pustular psoriasis can present with erythema and pustules that might resemble small fluid blisters.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing fasciitis: Although rare, this is a life-threatening infection that can start with erythema and blistering. Early recognition is crucial for survival.
- Toxic epidermal necrolysis (TEN): A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment. It can start with erythema and blisters.
- Rare diagnoses
- Autoimmune bullous dermatoses (e.g., bullous pemphigoid, pemphigus): These are rare conditions characterized by the formation of blisters due to an autoimmune response. They can present with erythema and blisters but are less common.
- Leukocytoclastic vasculitis: A condition characterized by inflammation of the blood vessels, which can present with skin lesions, including erythema and blisters, but it's relatively rare and usually associated with other systemic symptoms.