Differential Diagnosis for Pustules on Hands and Feet
Single Most Likely Diagnosis
- Pustular Psoriasis: This condition is characterized by the presence of pustules on the palms of the hands and soles of the feet, often accompanied by erythema and scaling. It is a form of psoriasis that can be triggered by various factors, including infections, medications, and systemic diseases.
Other Likely Diagnoses
- Dyshidrotic Eczema (Pompholyx): A type of eczema that presents with small, itchy blisters or pustules on the hands and feet, often related to stress, allergies, or environmental factors.
- Bacterial Infections (e.g., Staphylococcal or Streptococcal): Can cause pustular lesions on the hands and feet, especially in the context of compromised skin integrity or immunosuppression.
- Fungal Infections (e.g., Dermatophytosis): Can lead to pustular lesions, especially in the interdigital spaces of the feet, due to fungal infections like athlete's foot.
Do Not Miss Diagnoses
- Gonococcal Infection: Although less common, gonococcal infections can cause pustular lesions on the hands and feet, particularly in the context of sexually transmitted infections. Missing this diagnosis could lead to severe consequences, including disseminated infection.
- Sepsis or Septicemia: In rare cases, pustules on the hands and feet could be a sign of a systemic infection leading to sepsis, which is a life-threatening condition requiring immediate medical attention.
Rare Diagnoses
- Keratoderma Blennorrhagicum: A rare condition associated with reactive arthritis, characterized by pustular lesions on the palms and soles.
- Pustular Dermatosis of the Hands and Feet in Association with Other Systemic Diseases: Certain systemic diseases, such as inflammatory bowel disease or rheumatoid arthritis, can rarely present with pustular dermatosis on the hands and feet as an extraintestinal or extra-articular manifestation.