What is the cause of a pustular rash on the palms?

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Last updated: February 25, 2025View editorial policy

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Differential Diagnosis for Pustular Rash on Palms

  • Single most likely diagnosis
    • Palmoplantar pustulosis: This is a chronic skin condition characterized by the formation of pustules on the palms and soles. It is often associated with psoriasis and can be triggered by various factors, including stress and certain medications.
  • Other Likely diagnoses
    • Dyshidrotic eczema: A type of eczema that causes small, itchy blisters on the palms and soles, which can become pustular.
    • Pustular psoriasis: A rare form of psoriasis that causes pus-filled bumps on the skin, often on the palms and soles.
    • Acropustulosis: A rare skin condition that causes pustules on the palms and soles, often associated with other skin conditions such as psoriasis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Gonococcal infection: A bacterial infection that can cause pustular lesions on the palms and soles, often accompanied by other symptoms such as fever and joint pain.
    • Sepsis: A life-threatening condition that can cause a pustular rash on the palms and soles, often accompanied by other symptoms such as fever, chills, and organ dysfunction.
  • Rare diagnoses
    • Keratoderma blennorrhagicum: A rare skin condition that causes pustular lesions on the palms and soles, often associated with Reiter's syndrome.
    • Pustular dermatophytid: A rare skin condition that causes pustular lesions on the palms and soles, often associated with fungal infections.
    • Neutrophilic eccrine hidradenitis: A rare skin condition that causes pustular lesions on the palms and soles, often associated with chemotherapy or other medications.

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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