Differential Diagnosis for Beefy Red Scaling Rash

• Single most likely diagnosis
  • Psoriasis: The description of a beefy red scaling rash with a red wet base and plaques is highly suggestive of psoriasis, particularly the plaque type. The presence of well-defined erythematous plaques with silvery scales is a hallmark of this condition.
• Other Likely diagnoses
  • Seborrheic dermatitis: This condition can present with a red, scaling rash, particularly on the scalp, face, and torso. While it may not always have the characteristic "beefy red" appearance, the presence of scaling and redness makes it a plausible diagnosis.
  • Contact dermatitis: Allergic or irritant contact dermatitis can cause a red, scaling rash, especially if the patient has been exposed to an offending agent. The rash can be acute or chronic, and the presence of plaques is possible.
  • Eczema (atopic dermatitis): Eczema can present with a variety of skin manifestations, including red, scaling plaques. The condition often has a chronic course and can be associated with other atopic diseases.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Staphylococcal scalded skin syndrome (SSSS): Although less common, SSSS is a serious condition caused by staphylococcal toxins that can lead to widespread skin necrosis and detachment. The initial presentation can be a red, scaling rash, making it crucial not to miss this diagnosis.
  • Toxic epidermal necrolysis (TEN): TEN is a severe skin condition, often drug-induced, that can present with a red, scaling rash and progress to widespread skin necrosis. Early recognition is critical due to its high mortality rate.
  • Pemphigus vulgaris: An autoimmune blistering disease that can initially present with a red, scaling rash before progressing to blister formation. It is essential to consider this diagnosis due to its potential for severe morbidity and mortality if left untreated.
• Rare diagnoses
  • Pityriasis rubra pilaris: A rare skin disorder characterized by a red, scaling rash with an orange hue, often accompanied by palmoplantar keratoderma and other systemic symptoms.
  • Parapsoriasis: A group of rare skin conditions that can present with a red, scaling rash, often with an atypical appearance compared to more common dermatoses.