Migraine-related sensory symptoms: Abnormal tactile sensations can sometimes be a manifestation of migraine aura, even in the absence of headache. This condition is relatively common and can cause a variety of sensory disturbances.

Anxiety or stress-related symptoms: High levels of anxiety or stress can lead to abnormal sensations, including tactile disturbances, due to the body's heightened state of arousal.
Vitamin B12 deficiency: A deficiency in vitamin B12 can cause neurological symptoms, including abnormal sensations such as tingling or numbness, due to its role in the synthesis of myelin.
Peripheral neuropathy: Damage to the peripheral nerves can cause a range of sensory symptoms, including abnormal tactile sensations, due to the disruption of normal nerve function.

Multiple sclerosis: Although less common, multiple sclerosis (MS) can present with sporadic abnormal tactile sensations due to demyelination in the central nervous system. Missing this diagnosis could lead to delayed treatment and significant morbidity.
Stroke or transient ischemic attack (TIA): Sudden onset of abnormal tactile sensation could be a sign of a stroke or TIA, especially if accompanied by other focal neurological deficits. Prompt recognition is crucial for timely intervention.
Lyme disease: Neurological manifestations of Lyme disease can include abnormal sensations. Given its potential for serious complications if untreated, it's essential not to miss this diagnosis, especially in endemic areas.

Complex regional pain syndrome (CRPS): A rare condition characterized by intense burning or aching pain, often accompanied by abnormal sensations, typically following an injury. It's less likely but should be considered in the appropriate clinical context.
Erythromelalgia: A rare disorder that causes burning pain, heat, and redness in the hands and feet, sometimes accompanied by abnormal tactile sensations. Its rarity makes it a less likely diagnosis, but it's worth considering in patients with these specific symptoms.