Differential Diagnosis for Vesicle Rash on Hands and Palms
- Single most likely diagnosis
- Dyshidrotic Eczema (Pompholyx): This condition is characterized by the appearance of small, itchy vesicles on the palms and soles, often due to stress, allergies, or environmental factors. It's a common condition that matches the described symptoms closely.
- Other Likely diagnoses
- Contact Dermatitis: An allergic reaction or irritation from substances like metals (e.g., nickel), latex, or certain chemicals can cause a vesicular rash on the hands and palms.
- Herpes Simplex: Although more commonly associated with oral or genital areas, herpes simplex can occasionally cause vesicular lesions on the hands, known as herpetic whitlow.
- Vesicular Tinea (Ringworm): A fungal infection that can cause vesicular lesions, especially on the palms, though it's less common than other forms of tinea.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Secondary Syphilis: This condition can cause a variety of skin rashes, including vesicular ones on the palms and soles, and is critical to diagnose due to its potential for serious complications if left untreated.
- Hand, Foot, and Mouth Disease (HFMD): Caused by viruses like Coxsackievirus A, HFMD can lead to vesicular lesions on the hands and feet, and while usually benign, it can be serious in immunocompromised individuals.
- Rare diagnoses
- Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes, which can rarely present with vesicles on the hands and palms.
- Bullous Pemphigoid: Another autoimmune blistering disease that can occasionally present with vesicles on the palms, though it more commonly affects larger areas of the body.
- Dermatitis Herpetiformis: Characterized by intensely itchy, blistering skin, this condition is associated with celiac disease and can rarely cause vesicular rashes on the hands and palms.