Differential Diagnosis for Rheumatic Rash
Single Most Likely Diagnosis
- Acute Rheumatic Fever (ARF): Characterized by a migratory, erythematous rash, often accompanied by fever, joint pain, and cardiac involvement. The rash typically appears 1-3 weeks after a group A streptococcal infection.
Other Likely Diagnoses
- Lupus Erythematosus: A chronic autoimmune disease that can cause a butterfly-shaped rash on the face, as well as joint pain, fever, and kidney damage.
- Rheumatoid Arthritis (RA): An autoimmune disease that causes joint pain, swelling, and stiffness, often accompanied by a rash, particularly in the context of rheumatoid nodules.
- Psoriatic Arthritis: A condition that combines psoriasis with joint pain and inflammation, often presenting with a characteristic skin rash.
Do Not Miss Diagnoses
- Endocarditis: A potentially life-threatening infection of the heart valves, which can cause a rash (e.g., Janeway lesions), fever, and heart murmurs.
- Vasculitis: Inflammation of blood vessels, which can cause a rash, organ damage, and potentially life-threatening complications if left untreated.
- Sepsis: A severe, systemic infection that can cause a rash, fever, and organ failure, requiring prompt recognition and treatment.
Rare Diagnoses
- Relapsing Polychondritis: A rare autoimmune disease that causes recurring episodes of cartilage inflammation, potentially involving the skin, joints, and respiratory system.
- Ehlers-Danlos Syndrome: A group of genetic disorders that affect connective tissue, potentially causing skin hyperextensibility, joint hypermobility, and other systemic features.
- Sjögren's Syndrome: A rare autoimmune disorder that primarily affects the glands, causing dry eyes and mouth, but can also involve the skin and joints.