Differential Diagnosis for Skin Infection with Significant Pain
Single Most Likely Diagnosis
- Cellulitis: This is the most likely diagnosis given the symptoms of skin infection and significant pain upon touch. Cellulitis is a common bacterial skin infection that causes redness, swelling, and pain.
Other Likely Diagnoses
- Abscess: An abscess is a collection of pus that has built up within the tissue of the body, indicating a localized infection. It can cause significant pain, especially when touched or pressed.
- Erysipelas: A type of skin infection that affects the upper layer of the skin, erysipelas can cause pain, redness, and swelling, similar to cellulitis but typically more superficial and demarcated.
- Folliculitis: An inflammation of the hair follicles, folliculitis can cause pain, especially if it becomes infected. It might not always present with the inability to touch the skin due to pain but can be considered in the differential.
Do Not Miss Diagnoses
- Necrotizing Fasciitis: Although less common, necrotizing fasciitis is a severe infection that destroys the tissue under the skin, including fat and the tissue covering the muscles (fascia). It requires immediate medical attention and can be fatal if not treated promptly. The severe pain and tenderness, especially with skin touch, are red flags for this condition.
- Gas Gangrene: Caused by Clostridium perfringens, gas gangrene is a severe and potentially life-threatening condition characterized by necrosis of soft tissue with gas production. It can cause severe pain and is a medical emergency.
Rare Diagnoses
- Erythema Multiforme: A skin condition characterized by target lesions, erythema multiforme can sometimes cause discomfort but is less likely to cause significant pain upon touch compared to other conditions listed.
- Sweet Syndrome (Acute Febrile Neutrophilic Dermatosis): Characterized by fever, neutrophilia, and tender, erythematous skin lesions, Sweet syndrome can cause pain but is relatively rare and might not be the first consideration without other systemic symptoms.
- Pyoderma Gangrenosum: A rare skin condition that causes painful ulcers, pyoderma gangrenosum can be considered in the differential diagnosis of painful skin lesions, especially if there's a history of inflammatory bowel disease or other systemic conditions.