Differential Diagnosis for Scaling, Itching, and Redness of the Palms and Soles
Single Most Likely Diagnosis
- Dyshidrotic Eczema (Pompholyx): This condition is characterized by small, itchy blisters on the palms and soles, often accompanied by scaling and redness. It's a common condition that matches the symptoms described.
Other Likely Diagnoses
- Contact Dermatitis: This is a type of eczema caused by an allergic reaction or irritation from substances like soaps, detergents, or metals. It can cause scaling, itching, and redness on the palms and soles.
- Psoriasis: While psoriasis more commonly affects the elbows, knees, and scalp, it can also occur on the palms and soles, leading to thick, scaly patches and redness.
- Tinea Manuum or Tinea Pedis: Fungal infections of the hand (tinea manuum) or foot (tinea pedis), which can cause scaling, itching, and redness, especially in the skin folds.
Do Not Miss Diagnoses
- Syphilis (Secondary): In its secondary stage, syphilis can cause a rash on the palms and soles, which is a distinctive feature. Missing this diagnosis could lead to severe complications if left untreated.
- Lichen Planus: A chronic inflammatory condition that can affect the skin, including the palms and soles, causing purplish, itchy, flat bumps. It's less common but important not to miss due to its potential for significant morbidity.
Rare Diagnoses
- Keratoderma Blennorrhagicum: A rare condition associated with Reiter's syndrome, characterized by thickening of the skin on the palms and soles.
- Pityriasis Rubra Pilaris: A rare skin disorder that causes constant scaling, redness, and thickening of the skin, including on the palms and soles.
- Erythrokeratoderma: A group of rare genetic disorders that affect the skin, leading to well-demarcated, hyperkeratotic plaques on the palms and soles among other areas.