Differential Diagnosis for Pustular Rash
- Single most likely diagnosis
- Acne vulgaris: This is the most common condition associated with a pustular rash, particularly in adolescents and young adults, due to its high prevalence and the characteristic presence of comedones, papules, and pustules.
- Other Likely diagnoses
- Folliculitis: An inflammatory condition of the hair follicles, often caused by bacterial or fungal infections, which can present with pustules, especially in areas with high hair density.
- Impetigo: A contagious skin infection that can cause pustular lesions, typically seen in children, and is often caused by Staphylococcus aureus or Streptococcus pyogenes.
- Pustular psoriasis: A rare type of psoriasis characterized by the widespread appearance of pustules, often accompanied by erythema and scaling, which can be acute or chronic.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Staphylococcal scalded skin syndrome (SSSS): A severe condition caused by staphylococcal toxins that can lead to widespread skin exfoliation and is life-threatening, especially in neonates and young children.
- Toxic epidermal necrolysis (TEN): A severe skin condition, usually drug-induced, characterized by widespread skin necrosis and detachment, which is potentially fatal and requires immediate medical attention.
- Gonococcal infection: In the context of sexually transmitted infections, Neisseria gonorrhoeae can cause a pustular rash, and prompt diagnosis and treatment are crucial to prevent long-term complications.
- Rare diagnoses
- Subcorneal pustular dermatosis: A rare skin condition characterized by the formation of pustules just beneath the stratum corneum, often associated with autoimmune disorders or as an idiopathic condition.
- Acute generalized exanthematous pustulosis (AGEP): A rare, drug-induced condition that presents with numerous small pustules on a background of erythema, which, although rare, can be severe and requires immediate withdrawal of the offending drug.
- Sneddon-Wilkinson disease (Subcorneal pustular dermatosis): A rare skin disorder that presents with pustular eruptions and is often associated with other systemic conditions, requiring a comprehensive diagnostic approach.