Differential Diagnosis for Swollen Thighs, Red Peeling Legs, and Mottled Blue Feet
Single Most Likely Diagnosis
- Deep Vein Thrombosis (DVT) with Phlegmasia Cerulea Dolens: This condition is characterized by a severe form of DVT that leads to swelling, redness, and a blue discoloration of the affected limb due to impaired venous return. The absence of pain at rest is less typical but can occur, especially if the condition progresses to a point where nerve damage or significant ischemia alters pain perception.
Other Likely Diagnoses
- Cellulitis: An infection of the skin and subcutaneous tissues that can cause redness, swelling, and warmth. The peeling aspect might be related to the healing phase of the infection or a secondary condition like eczema or contact dermatitis.
- Chronic Venous Insufficiency: This condition can lead to swelling, skin changes (including redness and peeling), and a mottled appearance of the legs due to poor circulation.
- Lymphedema: Swelling of the limb due to impaired lymphatic drainage, which can also lead to skin changes and tightness.
Do Not Miss Diagnoses
- Acute Limb Ischemia: A sudden decrease in limb perfusion that can cause pain, pallor, pulselessness, poikilothermia, paresthesias, and paralysis. The absence of pain at rest does not rule out this condition, as pain can sometimes be absent in severe ischemia.
- Compartment Syndrome: Increased pressure within a muscle compartment that can lead to muscle and nerve damage. It typically presents with pain, especially on palpation or passive stretching, but in severe cases, nerve damage might reduce pain perception.
- Sepsis: A life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Skin manifestations can be varied and include redness, swelling, and discoloration.
Rare Diagnoses
- Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet. While it doesn't perfectly match the description, some variants could potentially present with swelling and peeling.
- Klippel-Trenaunay Syndrome: A rare congenital malformation that involves blood and lymph vessels, which can cause hypertrophy of the limb, varicose veins, and other skin changes.
- Blue Toe Syndrome: A condition caused by cholesterol crystal embolization that can lead to a sudden onset of a blue, painful toe. It might not fully match the description but is worth considering in the differential for mottled blue discoloration.