Differential Diagnosis for 57 year old female with fingers peeling with numbness

• Single most likely diagnosis
  • Peripheral Neuropathy: This condition is characterized by damage to the peripheral nerves, which can cause numbness, tingling, and peeling skin on the fingers due to autonomic dysfunction affecting sweat and oil glands.
• Other Likely diagnoses
  • Raynaud's Phenomenon: A condition that affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips. It can cause the skin to peel and become numb due to reduced blood flow.
  • Diabetic Neuropathy: High blood sugar levels can damage nerves, leading to numbness and peeling skin, especially in the extremities.
  • Vitamin Deficiency (B12 or B6): Deficiencies in these vitamins can cause neurological symptoms, including numbness and skin problems like peeling.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Scleroderma: An autoimmune disease that can cause skin thickening, numbness, and peeling, especially in the fingers. It can lead to serious complications if not treated promptly.
  • Leprosy (Hansen's Disease): A chronic bacterial infection that can cause numbness, skin lesions, and peeling, particularly in the extremities. Early diagnosis is crucial to prevent long-term damage.
• Rare diagnoses
  • Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, and can also lead to peeling skin and numbness.
  • Porphyria: A group of rare genetic disorders that can cause a range of symptoms, including numbness, skin blistering, and peeling, especially after sun exposure.