Differential Diagnosis for Redness of Soles and Hands, Sore Throat, and Peeling Skin on Feet

• Single Most Likely Diagnosis
  • Kawasaki Disease: This condition is characterized by fever, rash, swelling of hands and feet, redness of the eyes, lips, and throat, and is often accompanied by peeling skin on the hands and feet. The combination of symptoms provided closely matches the clinical presentation of Kawasaki disease, making it the most likely diagnosis.
• Other Likely Diagnoses
  • Scarlet Fever: Caused by Group A beta-hemolytic streptococcal infection, it presents with a sore throat, fever, and a characteristic rash that can include redness of the palms and soles. The peeling skin could be a later manifestation.
  • Toxic Shock Syndrome: Although more severe, it can present with fever, rash, and desquamation (peeling skin), especially on the palms and soles. A sore throat could be part of the initial infection leading to the syndrome.
• Do Not Miss Diagnoses
  • Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, it leads to widespread skin exfoliation, which can start around areas of infection or irritation, including the hands and feet. A sore throat could be an initial focus of infection.
  • Toxic Epidermal Necrolysis (TEN): A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment. It's less likely but critical to identify due to its high mortality rate.
• Rare Diagnoses
  • Pityriasis Rubra Pilaris (PRP): A rare skin disorder characterized by constant scaling, redness, and thickening of the skin, which can include the palms and soles. While it doesn't typically present with a sore throat, it's a consideration in the differential for chronic skin conditions.
  • Erythema Multiforme: An immune-mediated disorder that can present with skin lesions and sometimes mucosal involvement, including the throat. It's less likely to cause peeling skin on the feet but should be considered in a broad differential for skin rashes.