Differential Diagnosis for Honeycomb Lesions in Hand
- Single most likely diagnosis
- Sarcoidosis: This condition is known for causing skin lesions, including those with a honeycomb appearance, particularly in the hands and fingers. It's an autoimmune disease that can affect multiple organs, and skin manifestations are common.
- Other Likely diagnoses
- Psoriasis: A chronic skin condition that can cause thick, scaly, or honeycomb-like lesions, especially on the palms of the hands. The appearance and location can sometimes mimic other conditions.
- Eczema (Dyshidrotic): Characterized by small, itchy blisters on the hands and feet, which can sometimes appear as honeycomb lesions, especially in severe cases or after scratching.
- Keratoderma: A group of disorders characterized by thickening of the skin on the palms and soles, which can sometimes present with a honeycomb appearance due to the formation of deep fissures.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignancy (e.g., Squamous Cell Carcinoma): Although less common, skin cancers can present with unusual lesions. A biopsy is crucial for diagnosis, especially if there's a history of exposure to carcinogens or if the lesion is resistant to treatment.
- Infections (e.g., Deep Fungal Infections): Certain fungal infections can cause lesions that might resemble a honeycomb pattern, especially in immunocompromised patients. These can be serious and require prompt antifungal treatment.
- Rare diagnoses
- Pityriasis Rubra Pilaris: A rare skin disorder that can cause constant scaling, redness, and thickening of the skin, potentially leading to a honeycomb appearance in some cases.
- Keratosis Pilaris: While more common on the arms and thighs, in rare instances, it can affect the hands, causing small, rough, sandpapery bumps that might be described as honeycomb-like in severe cases.
- Scleroderma: An autoimmune disease that can cause skin thickening and hardening, potentially leading to lesions or changes that might be confused with a honeycomb pattern, especially in advanced stages.