Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: July 12, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Violaceous Oval Macules

Single Most Likely Diagnosis

  • Janeway Lesions: These are small, violaceous, oval macules that are often seen on the palms and soles in patients with infective endocarditis. They are a result of septic emboli and are considered a classic sign of this condition.

Other Likely Diagnoses

  • Palpable Purpura: This condition presents with violaceous oval macules or papules that are palpable, indicating inflammation of the blood vessels (vasculitis). It can be associated with various conditions, including Henoch-Schönlein purpura, Wegener's granulomatosis, and microscopic polyangiitis.
  • Lichen Planus: While not typically violaceous, some forms of lichen planus, especially when involving the mucous membranes or in certain ethnic groups, can present with violaceous oval macules. The presence of Wickham's striae and other characteristic lesions can help differentiate it.
  • Erythema Multiforme: This is an immune-mediated condition that can present with a variety of skin lesions, including violaceous oval macules, often with a targetoid appearance. It is usually triggered by infections or medications.

Do Not Miss Diagnoses

  • Meningococcemia: This is a life-threatening condition caused by Neisseria meningitidis, which can present with a rash that may initially appear as violaceous oval macules but quickly progresses to purpura. Early recognition is crucial for survival.
  • Rocky Mountain Spotted Fever (RMSF): Caused by Rickettsia rickettsii, RMSF can present with a rash that starts as small, flat, violaceous spots that may appear a few days after the onset of fever. It is essential to consider this diagnosis in patients with a history of tick exposure.

Rare Diagnoses

  • Kaposi's Sarcoma: This is a type of cancer that can cause violaceous lesions, especially in immunocompromised patients, such as those with HIV/AIDS. The lesions can appear anywhere on the body and may resemble oval macules.
  • Angiokeratoma Corporis Diffusum (Fabry Disease): A genetic disorder that leads to the accumulation of a particular type of fat in the body's cells, affecting many parts of the body. It can cause violaceous lesions, among other symptoms, due to the involvement of blood vessels.

Related Questions

Is piperacillin-tazobactam (Pip/Taz) effective for treating typhoid fever?
What are the treatment options for hallux valgus?
Does calciphylaxis cause skin itching?
Does marijuana (cannabis) increase the risk of lung cancer, or is it due to co-use with tobacco?
What is the next step for a patient experiencing nausea with a Nasogastric (NG) tube?
What is the best next step for a middle-aged female with intraductal carcinoma (DCIS) and involved margins after excision of a 3 cm breast lump?

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question