Differential Diagnosis for Unilateral Hand Swelling, Warmth, and Itching
Single Most Likely Diagnosis
- Cellulitis: This is a common condition characterized by skin infection, typically caused by bacteria such as Streptococcus or Staphylococcus. The symptoms of cellulitis include redness, warmth, swelling, and sometimes itching, which align with the described symptoms. The fact that it occurred on two separate occasions and affected both hands suggests a recurring or episodic condition, which could be related to bacterial infections.
Other Likely Diagnoses
- Contact Dermatitis: This condition occurs when the skin comes into contact with an irritant or allergen, leading to inflammation, which can cause itching, redness, and swelling. Given the unilateral and episodic nature, exposure to specific substances could be a recurring issue.
- Insect Bite or Sting: Reactions to insect bites or stings can cause localized swelling, warmth, and itching. The fact that both hands were affected at different times could suggest separate incidents of bites or stings.
- Angioedema: Although typically more severe and involving deeper tissues, angioedema can cause swelling and itching. If it's limited to the hands and occurs episodically, it could be considered, especially if there's a history of allergic reactions.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although DVT typically presents with pain and swelling, it's crucial not to miss this diagnosis due to the risk of pulmonary embolism. Warmth and swelling could be mistaken for infection or inflammation, but DVT requires immediate medical attention.
- Necrotizing Fasciitis: A severe infection that affects the tissue beneath the skin and surrounding muscles and organs. It's characterized by severe pain, swelling, and redness, and can be life-threatening if not treated promptly.
Rare Diagnoses
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. It could be considered if the episodes of swelling, warmth, and itching are accompanied by significant pain.
- Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the skin, and might present with swelling, warmth, and itching, although it's less common and would typically be accompanied by other systemic symptoms.
- Complex Regional Pain Syndrome (CRPS): Characterized by severe, burning pain at the site of an injury, CRPS can also cause swelling, warmth, and changes in skin texture, although it's more associated with trauma and chronic pain.