Differential Diagnosis for Vesicular Rash
- Single most likely diagnosis
- Varicella (Chickenpox): This is the most common cause of a vesicular rash, especially in children, characterized by a pruritic, vesicular rash in different stages of healing.
- Other Likely diagnoses
- Herpes Zoster (Shingles): Caused by the reactivation of the varicella-zoster virus, it presents as a painful, vesicular rash usually confined to a single dermatome.
- Herpes Simplex Virus (HSV) infections: Both HSV-1 and HSV-2 can cause vesicular rashes, typically around the oral or genital areas.
- Contact Dermatitis: Certain allergens or irritants can cause a vesicular rash upon contact with the skin.
- Dyshidrotic Eczema: A type of eczema characterized by small, itchy blisters on the hands or feet.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Although rare, these conditions are life-threatening and can present with vesicular rashes, along with mucosal involvement and skin necrosis.
- Primary Herpes Simplex Virus infection: In immunocompromised patients, primary HSV infection can be severe and disseminated.
- Rare diagnoses
- Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes.
- Bullous Pemphigoid: Another autoimmune disease characterized by the formation of blisters on the skin.
- Hand, Foot, and Mouth Disease (HFMD): Caused by viruses like Coxsackievirus A, it presents with vesicular rashes on the hands, feet, and mouth, more common in children.
- Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, it leads to widespread blistering of the skin, primarily in infants and young children.