Differential Diagnosis for Hand, Foot, and Mouth Disease (HFMD) Like Rash

• Single most likely diagnosis:
  • Hand, Foot, and Mouth Disease (HFMD) - This is the most likely diagnosis due to the characteristic rash distribution on the hands, feet, and mouth, which is typical for HFMD, especially in children.
• Other Likely diagnoses:
  • Coxsackievirus A6 infection - Similar to HFMD, but can cause more severe symptoms and is known for its association with outbreaks of HFMD-like illness.
  • Enterovirus 71 infection - Another common cause of HFMD, which can sometimes lead to more severe neurological complications.
  • Herpangina - Caused by coxsackieviruses, it presents with mouth sores but can also have a rash, though it's less common on the hands and feet.
• Do Not Miss diagnoses:
  • Meningococcemia - Although rare, this condition can present with a rash and is life-threatening if not promptly treated. The rash in meningococcemia is typically petechial or purpuric, not exactly like HFMD, but the severity of the disease warrants consideration.
  • Rocky Mountain Spotted Fever (RMSF) - This tick-borne illness can cause a rash on the hands and feet, among other symptoms, and is critical to diagnose early due to its potential severity.
• Rare diagnoses:
  • Kawasaki Disease - An acute febrile illness that can cause rash, among other symptoms like fever, conjunctivitis, and lymphadenopathy. The rash can vary in appearance and distribution.
  • Erythema Multiforme - A skin condition characterized by target lesions, which can appear on the hands and feet, though it's not typically the first consideration for a HFMD-like rash.