Differential Diagnosis for Painful Rash on Soles and Palms
Single Most Likely Diagnosis
- Hand, Foot, and Mouth Disease (HFMD): A common viral illness, typically caused by coxsackievirus A or enterovirus 71, characterized by a painful rash on the soles and palms, along with fever and oral ulcers. This diagnosis is most likely due to the specific location of the rash and the common occurrence of HFMD.
Other Likely Diagnoses
- Eczema (Dyshidrotic): A type of eczema that affects the palms and soles, causing small, itchy blisters and a painful rash. This condition is likely due to its prevalence and the typical locations of the rash.
- Psoriasis (Palmoplantar): A form of psoriasis that affects the palms and soles, causing red, scaly, and painful patches. This diagnosis is considered likely due to the specific locations of the rash and the commonality of psoriasis.
- Keratoderma Blennorrhagicum: A skin condition associated with reactive arthritis, characterized by a painful rash on the palms and soles. This diagnosis is likely due to the specific locations of the rash and the potential for systemic symptoms.
Do Not Miss Diagnoses
- Secondary Syphilis: A systemic infection caused by Treponema pallidum, which can cause a painful rash on the palms and soles. This diagnosis is crucial to consider due to the potential for severe complications if left untreated.
- Toxic Shock Syndrome: A life-threatening condition caused by bacterial toxins, which can cause a painful rash on the palms and soles, along with fever and other systemic symptoms. This diagnosis is critical to consider due to its high mortality rate if not promptly treated.
Rare Diagnoses
- Pityriasis Rubra Pilaris: A rare skin disorder characterized by a painful rash on the palms and soles, along with other systemic symptoms. This diagnosis is considered rare due to its low prevalence and the need for specific diagnostic criteria.
- Acrokeratosis Neoplastica: A rare skin condition associated with internal malignancies, characterized by a painful rash on the palms and soles. This diagnosis is rare due to its low prevalence and the need for further diagnostic testing to confirm an underlying malignancy.