Differential Diagnosis for Papules Starting in the Mouth and Synchronously Maturing into Vesicular Lesions
- Single most likely diagnosis
- Hand, Foot, and Mouth Disease (HFMD): This is a common viral illness that typically starts with oral papules or vesicles, which can then spread to the hands and feet. The synchronous maturation of lesions is consistent with this diagnosis.
- Other Likely diagnoses
- Herpangina: This condition is characterized by the sudden onset of oral vesicular lesions, often accompanied by fever and sore throat. While it primarily affects children, it could be considered in the differential diagnosis for similar presentations.
- Primary Herpes Simplex Virus (HSV) infection: The initial presentation of HSV can include oral vesicles or ulcers, which could fit the described symptoms. However, the pattern of starting in the mouth and then maturing into vesicular lesions might not be as typical for HSV as for HFMD.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN): Although rare, these conditions are life-threatening and can start with mucosal lesions, including in the mouth, before progressing to widespread skin detachment. Early recognition is crucial for management.
- Pemphigus Vulgaris: An autoimmune disease that can present with oral lesions, which then progress to skin lesions. It's less common but critical to diagnose early due to its potential severity and the need for specific treatment.
- Rare diagnoses
- Enterovirus 71 infection: While more commonly associated with HFMD, certain strains can cause more severe neurological or systemic diseases. The presentation might be atypical and could include oral and vesicular lesions.
- Acute Pustulosis due to viral infections (e.g., Coxsackievirus A6): This can cause widespread pustular lesions, including in the mouth, and is seen in conditions like acute generalized exanthematous pustulosis, though the primary description might not perfectly align with the question's specifics.