Differential Diagnosis for Painful Skin to Touch

• Single most likely diagnosis
  • Allodynia (often associated with neuropathic pain conditions such as fibromyalgia or postherpetic neuralgia): This condition is characterized by pain from stimuli that do not normally provoke pain, such as light touch or clothing on the skin. It's a common complaint in various neuropathic pain syndromes.
• Other Likely diagnoses
  • Eczema/Dermatitis: Inflammatory skin conditions can cause the skin to be sensitive and painful to touch, including the touch of clothing.
  • Burns: Fresh burns or healing burns can be extremely sensitive, making it painful for clothes to touch the skin.
  • Sunburn: Similar to burns, sunburned skin can be very sensitive and painful to the touch, including the touch of clothing.
  • Shingles: Before the rash appears, or in the healing stages, shingles can cause significant sensitivity and pain to light touch.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Sepsis: Though less common, sepsis can cause widespread pain and sensitivity, including pain from light touch or clothing on the skin, due to the body's systemic inflammatory response.
  • Neurological conditions (e.g., multiple sclerosis, peripheral neuropathy): Certain neurological conditions can lead to abnormal sensations, including allodynia, which would make it painful for clothes to touch the skin.
• Rare diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can also involve sensitivity to touch.
  • Fabry Disease: A genetic disorder that can lead to neuropathic pain and sensitivity, among other symptoms.
  • Complex Regional Pain Syndrome (CRPS): A condition characterized by intense burning or aching pain in the hands or feet after an injury, which can also include sensitivity to touch or clothing.