Differential Diagnosis
The physical exam findings of small, dome-shaped areas on bilateral feet, extending upward, with no noted lesions on the buttock or groin area, and a flat, rough area on the abdomen, can be approached with the following differential diagnosis:
- Single most likely diagnosis
- Tinea pedis and tinea corporis: The description of small, dome-shaped areas on the feet, extending upward, is consistent with tinea pedis (athlete's foot), while the flat, rough area on the abdomen could be tinea corporis (ringworm of the body). These fungal infections are common and can present with similar physical exam findings.
- Other Likely diagnoses
- Eczema (atopic dermatitis): The rough area on the abdomen could be consistent with eczema, and the lesions on the feet could be a manifestation of dyshidrotic eczema.
- Psoriasis: The description of small, dome-shaped areas on the feet could be consistent with psoriatic plaques, and the rough area on the abdomen could be a manifestation of psoriasis on the trunk.
- Keratosis pilaris: The rough area on the abdomen could be consistent with keratosis pilaris, a common skin condition characterized by small, rough patches on the skin.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cutaneous lymphoma: Although rare, cutaneous lymphoma can present with skin lesions that resemble those described in the physical exam. It is essential to consider this diagnosis to avoid missing a potentially life-threatening condition.
- Cutaneous metastases: In rare cases, skin lesions can be a manifestation of an underlying malignancy. It is crucial to consider this diagnosis, especially if there are other systemic symptoms or a history of cancer.
- Rare diagnoses
- Pityriasis rubra pilaris: A rare skin condition characterized by small, rough patches on the skin, which could be consistent with the description of the rough area on the abdomen.
- Darier's disease: A rare genetic disorder that can present with skin lesions, including rough, flat areas on the abdomen and feet.