Differential Diagnosis for Intense Itching on Palms
Single Most Likely Diagnosis
- Irritant Contact Dermatitis: This is the most likely diagnosis given the patient's occupation in the steel industry and the use of gloves, which can cause irritation and allergic reactions. The presence of erythematous palms supports this diagnosis.
Other Likely Diagnoses
- Allergic Contact Dermatitis: Similar to irritant contact dermatitis, but this would be an allergic reaction to a specific substance the patient comes into contact with at work or through the gloves.
- Dry Skin (Xerosis): Prolonged use of gloves can lead to dry skin, which may cause itching.
- Psoriasis: Although less common on the palms, psoriasis can cause intense itching and erythema.
Do Not Miss Diagnoses
- Scabies: Although the lack of a rash might make this less likely, scabies can cause intense itching, especially on the palms, and is highly contagious. Missing this diagnosis could lead to outbreaks.
- Pompholyx (Dyshidrotic Eczema): Characterized by small, itchy blisters on the palms, this condition can be debilitating and requires proper treatment.
Rare Diagnoses
- Keratoderma: A group of rare skin conditions that cause thickening of the skin on the palms and soles, which can lead to itching.
- Idiopathic Erythema of the Palms: A rare condition characterized by recurrent episodes of erythema and itching of the palms without an identifiable cause.
- Systemic Diseases with Skin Manifestations: Certain systemic diseases, such as liver disease or kidney failure, can cause itching all over the body, including the palms, though these would typically be accompanied by other systemic symptoms.