Differential Diagnosis for Small, Sinular Red Dot Surrounded by White Associated with Vascular Issues
- Single Most Likely Diagnosis
- Janeway Lesions: These are small, painless, erythematous or hemorrhagic macules on the palms and soles, often associated with infective endocarditis. The description of a small, sinular red dot surrounded by white fits this condition, especially given the context of vascular issues like livedo reticularis, which can also be seen in infective endocarditis.
- Other Likely Diagnoses
- Osler's Nodes: These are painful, indurated lesions that are also associated with infective endocarditis. While they are typically more painful and larger than the described lesion, they can present in various forms and are relevant given the vascular context.
- Livedo Reticularis with Central Blanching or Infarction: This condition presents as a mottled, reticular discoloration of the skin and can be associated with various vascular and autoimmune diseases. Central areas of livedo reticularis can sometimes appear as red dots surrounded by white due to central blanching or infarction.
- Do Not Miss Diagnoses
- Septic Emboli: These can present as small, red, painful lesions and are a critical diagnosis to consider, especially in the context of suspected endocarditis or other severe infections. Missing this diagnosis could lead to significant morbidity or mortality.
- Vasculitis: Various forms of vasculitis (e.g., small vessel vasculitis) can present with skin lesions that might fit the description, along with systemic symptoms. Vasculitis can be life-threatening and requires prompt diagnosis and treatment.
- Rare Diagnoses
- Cholesterol Crystal Embolization: This condition occurs when cholesterol crystals break off from plaques in the arteries and travel to smaller vessels, causing occlusion. It can present with livedo reticularis and possibly small, red lesions due to infarction or inflammation.
- Antiphospholipid Syndrome: This autoimmune disorder can cause vascular thrombosis and livedo reticularis. While less common, it's a consideration in patients with recurrent thrombotic events or specific antibody profiles.