Differential Diagnosis for Chronic Hand Rash

• Single most likely diagnosis
  • Dyshidrotic eczema: This condition is characterized by small, itchy blisters on the hands, often recurring and chronic. It's a common condition that matches the description of a chronic hand rash.
• Other Likely diagnoses
  • Atopic dermatitis: A form of eczema that can cause chronic rashes on the hands, among other areas. It's known for its itchy and inflamed skin.
  • Contact dermatitis: This can be either irritant or allergic, caused by exposure to substances that irritate the skin or trigger an allergic reaction, leading to a chronic rash if exposure continues.
  • Psoriasis: A chronic skin condition that can cause thick, scaly, red patches on the hands, among other areas. It's known for its cycles of flare-ups and remission.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Squamous cell carcinoma: Although rare, skin cancers can present as chronic rashes. Early detection is crucial for effective treatment.
  • Lymphoma (cutaneous T-cell lymphoma): Certain types of lymphoma can initially present with skin symptoms, including rashes. Missing this diagnosis could lead to delayed treatment of a potentially fatal disease.
• Rare diagnoses
  • Pompholyx: A type of eczema that causes blisters on the hands and feet, similar to dyshidrotic eczema but less common.
  • Keratodermas: A group of rare skin conditions that cause thickening of the skin on the palms and soles, which could be mistaken for a chronic rash.
  • Secondary syphilis: Can cause a rash on the palms of the hands, among other symptoms. Although rare in the context of chronic hand rashes, it's an important consideration due to its implications for public health and the need for antibiotic treatment.