Differential Diagnosis for Finger Tips Peeling in Adults

Single Most Likely Diagnosis

• Dry Skin (Xerosis): This is the most common cause of peeling fingertips in adults, often due to environmental factors such as cold weather, excessive hand washing, or the use of harsh soaps.

Other Likely Diagnoses

• Eczema (Atopic Dermatitis): A chronic skin condition characterized by itchy, inflamed skin, which can lead to peeling, especially if the fingertips are involved.
• Psoriasis: An autoimmune condition that speeds up the life cycle of skin cells, causing cells to build up rapidly on the surface of the skin, leading to scaling and peeling.
• Contact Dermatitis: A type of skin inflammation caused by contact with irritants or allergens, which can result in peeling of the skin on the fingertips.
• Keratolysis Exfoliativa: A condition characterized by recurrent episodes of peeling of the skin on the palms and soles, often triggered by environmental factors.

Do Not Miss Diagnoses

• Pemphigus: A group of rare skin disorders that cause blistering of the skin and mucous membranes, which can lead to peeling and can be life-threatening if not treated promptly.
• Staphylococcal Scalded Skin Syndrome (SSSS): A condition caused by staphylococcal toxins that can lead to widespread skin peeling, more common in children but can occur in adults with significant morbidity.
• Toxic Epidermal Necrolysis (TEN): A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment, which is life-threatening and requires immediate medical attention.

Rare Diagnoses

• Kawasaki Disease: Although more common in children, this condition can rarely occur in adults and is characterized by fever, rash, and desquamation (peeling) of the skin, particularly on the fingertips.
• Reactive Arthritis (formerly Reiter's Syndrome): A type of arthritis that occurs as a reaction to an infection elsewhere in the body, which can include skin manifestations such as keratoderma blennorrhagicum, leading to peeling of the skin on the fingertips.
• Pityriasis Rubra Pilaris: A rare skin disorder characterized by constant scaling (peeling), and which can involve the fingertips among other areas.