Differential Diagnosis for Toe Swelling

• Single most likely diagnosis
  • Cellulitis: The patient's complaint of toe swelling that is spreading to adjacent toes is a classic presentation of cellulitis, a common bacterial skin infection. The use of compression hose may have contributed to the development of the infection by causing skin irritation or compromising skin integrity.
• Other Likely diagnoses
  • Deep Vein Thrombosis (DVT): Although the patient is wearing compression hose, which is often used to prevent DVT, it is still possible for a DVT to occur, especially if the compression is inadequate or if the patient has other risk factors.
  • Contact Dermatitis: The compression hose could be causing an allergic reaction or irritation, leading to swelling and inflammation of the toes.
  • Eczema/Dyshidrotic Eczema: A skin condition characterized by small, itchy blisters on the toes, which could be exacerbated by the compression hose.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Necrotizing Fasciitis: A life-threatening infection that can cause rapid progression of swelling, pain, and skin necrosis. Although rare, it is essential to consider this diagnosis due to its high mortality rate.
  • Gas Gangrene: Another rare but potentially deadly infection that can cause swelling, pain, and crepitus (a grating or bubbling feeling under the skin).
• Rare diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and swelling in the toes, often associated with myeloproliferative disorders.
  • Complex Regional Pain Syndrome (CRPS): A rare condition characterized by chronic pain, swelling, and skin changes in the affected limb, often following trauma or injury.