What is the cause of a red rash on the palmar surface of the hand?

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Differential Diagnosis for Red Rash on the Palm of the Hand

Single Most Likely Diagnosis

  • Dyshidrotic Eczema (Pompholyx): This condition is characterized by small, itchy blisters on the palms of the hands or soles of the feet. It's a common cause of a red rash in these areas, often related to stress, allergies, or environmental factors.

Other Likely Diagnoses

  • Contact Dermatitis: An allergic reaction or irritation from substances like soap, detergent, or certain metals can cause a red rash on the palms.
  • Psoriasis: Although less common on the palms, psoriasis can cause red, scaly patches in this area, especially in patients with a history of the condition.
  • Palmar Erythema: This condition involves reddening of the palms due to increased blood flow and can be associated with various factors, including pregnancy, liver disease, or thyroid disorders.

Do Not Miss Diagnoses

  • Secondary Syphilis: A rash on the palms of the hands can be a sign of secondary syphilis, a sexually transmitted infection. Missing this diagnosis could lead to severe complications if left untreated.
  • Lyme Disease: Although the characteristic "bull's-eye" rash of Lyme disease typically appears on the trunk, arms, or legs, it can occasionally occur on the palms. Early diagnosis is crucial to prevent long-term consequences.

Rare Diagnoses

  • Keratoderma Blennorrhagicum: A rare condition associated with Reiter's syndrome, characterized by a rash on the palms and soles, often accompanied by arthritis and urethritis.
  • Pityriasis Rubra Pilaris: A rare skin disorder that can cause a red rash on the palms, among other areas, and is often accompanied by scaling and thickening of the skin.

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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