What is the cause of a rash with small vesicles on and between the toes, also known as interdigital vesicular rash?

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Differential Diagnosis for Rash with Small Vesicles on and Between Toes

  • Single most likely diagnosis
    • Dyshidrotic eczema (pompholyx): This condition is characterized by the appearance of small, itchy vesicles on the palms and soles, often between the toes. It's a common condition that can be triggered by stress, allergies, or environmental factors.
  • Other Likely diagnoses
    • Tinea pedis (athlete's foot): A fungal infection that can cause a rash with small vesicles, especially between the toes. It's often accompanied by itching, burning, and cracking of the skin.
    • Contact dermatitis: An allergic or irritant reaction to substances like soap, detergent, or certain metals, which can cause a rash with small vesicles on the skin, including between the toes.
    • Psoriasis: An autoimmune condition that can cause a rash with small vesicles or pustules, often on the soles of the feet or between the toes.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Erythema multiforme: A rare but potentially life-threatening condition that can cause a rash with target-like lesions, including small vesicles, often in response to an infection or medication.
    • Toxic epidermal necrolysis (TEN): A severe skin condition usually triggered by medications, which can cause widespread skin necrosis and detachment, including small vesicles.
  • Rare diagnoses
    • Pustular psoriasis: A rare form of psoriasis that can cause a rash with small pustules or vesicles, often on the palms and soles.
    • Keratoderma blennorrhagicum: A rare condition associated with reactive arthritis, which can cause a rash with small vesicles or pustules on the soles of the feet.
    • Id reaction: A rare, immune-mediated reaction that can cause a rash with small vesicles, often in response to a fungal infection like tinea pedis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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