Differential Diagnosis for Visibly Pulsating Erythema on the Dorsal Bilateral Hands
- Single Most Likely Diagnosis
- Vasculitis: This condition involves inflammation of the blood vessels and can cause visibly pulsating erythema due to the increased blood flow and vessel wall damage. The bilateral involvement suggests a systemic rather than localized cause.
- Other Likely Diagnoses
- Thyroid Acropachy: Associated with autoimmune thyroid disease, this condition can cause erythema, warmth, and pulsations in the hands and feet due to increased blood flow.
- Raynaud's Phenomenon: Although typically characterized by episodic vasospasm, some patients may exhibit persistent erythema and warmth between episodes, potentially mimicking pulsating erythema.
- Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, which could be mistaken for pulsating erythema due to the increased blood flow to the affected areas.
- Do Not Miss Diagnoses
- Endocarditis: Infective endocarditis can cause systemic emboli, including to the hands, leading to localized signs such as erythema and potentially pulsating lesions if they involve the vascular system directly.
- Vasculitic Disorders (e.g., ANCA-associated vasculitis, Lupus): These conditions can present with a wide range of symptoms, including skin manifestations like erythema, and are critical to diagnose early due to their potential for severe organ damage.
- Aortic Regurgitation: Severe aortic regurgitation can lead to increased peripheral pulses and potentially visible pulsations in the hands, although this would typically be accompanied by other signs of heart failure.
- Rare Diagnoses
- Arteriovenous Malformations (AVMs): Although rare, AVMs in the hands could potentially cause localized erythema and pulsations due to the abnormal connection between arteries and veins.
- Maffucci Syndrome: A rare genetic disorder characterized by multiple enchondromas (cartilage tumors) and hemangiomas, which could potentially cause visible pulsations if the hemangiomas are located in the hands.
- Klippel-Trenaunay Syndrome: A congenital condition involving vascular malformations that could lead to increased blood flow and visible pulsations in the affected limbs.