What is the cause of a rash on the palms and soles accompanied by eosinophilia (elevated eosinophil count)?

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Differential Diagnosis for Rash in Palms and Soles with Eosinophilia

  • Single Most Likely Diagnosis
    • Palmoplantar Pustulosis: This condition is characterized by the presence of sterile pustules on the palms and soles, often accompanied by eosinophilia. It is a common cause of palmoplantar rash and the presence of eosinophilia supports this diagnosis.
  • Other Likely Diagnoses
    • Dyshidrotic Eczema (Pompholyx): A type of eczema that affects the palms and soles, characterized by small, itchy blisters. Eosinophilia can be present, especially if there is an allergic component.
    • Scabies: A parasitic infection caused by the mite Sarcoptes scabiei, which can lead to a rash on the palms and soles, along with eosinophilia due to the body's immune response.
    • Contact Dermatitis: An allergic or irritant reaction to substances that come into contact with the skin, which can cause a rash on the palms and soles. Eosinophilia may be present, particularly in allergic contact dermatitis.
  • Do Not Miss Diagnoses
    • Acute HIV Infection: Some patients with acute HIV infection can present with a rash on the palms and soles, accompanied by eosinophilia. Missing this diagnosis could have significant consequences.
    • Syphilis (Secondary): Secondary syphilis can cause a rash on the palms and soles, along with various other symptoms. Eosinophilia may be present, and missing this diagnosis could lead to serious complications if left untreated.
  • Rare Diagnoses
    • Erythema Multiforme: A skin condition characterized by target lesions, which can occasionally affect the palms and soles. Eosinophilia may be present, especially if there is an infectious or allergic trigger.
    • Keratoderma Blennorrhagicum: A rare condition associated with reactive arthritis, characterized by a rash on the palms and soles. Eosinophilia can occur, particularly if there is an underlying infection.

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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