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Last updated: September 11, 2025View editorial policy

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Differential Diagnosis for Rash on Hands

  • Single most likely diagnosis
    • Contact Dermatitis: This is often the most common cause of a rash on the hands, resulting from exposure to allergens or irritants such as soaps, detergents, or certain metals. The rash typically appears as red, itchy, and inflamed skin.
  • Other Likely diagnoses
    • Eczema (Atopic Dermatitis): A chronic condition characterized by dry, itchy, and inflamed skin. It often affects the hands, especially in individuals with a history of allergies or asthma.
    • Psoriasis: An autoimmune condition leading to thick, scaly, red patches on the skin, which can occur on the hands. It's associated with other systemic symptoms and a family history of the condition.
    • Dyshidrotic Eczema: A type of eczema that specifically affects the hands and feet, characterized by small, itchy blisters.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Toxic Epidermal Necrolysis (TEN) or Stevens-Johnson Syndrome (SJS): Although rare, these are life-threatening conditions usually triggered by medications, leading to widespread skin necrosis and detachment. Early recognition is crucial for survival.
    • Secondary Syphilis: Can cause a rash on the palms of the hands, among other symptoms. It's critical to diagnose and treat syphilis to prevent long-term complications and transmission.
  • Rare diagnoses
    • Pompholyx: A rare condition characterized by the appearance of small, itchy blisters on the hands, often associated with an allergic reaction or idiosyncratic response.
    • Keratoderma: A group of rare genetic disorders leading to thickening of the skin on the palms and soles, which can be associated with other systemic conditions.
    • Mycosis Fungoides: A rare type of cutaneous T-cell lymphoma that can initially present with skin lesions resembling eczema or dermatitis on the hands, among other areas.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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