Differential Diagnosis for Red Papules on Hands
- Single most likely diagnosis
- Keratoderma blennorrhagicum: This condition is characterized by the appearance of red, scaly papules on the hands and feet, often associated with Reiter's syndrome. The presence of red papules on the hands could be a strong indicator of this condition, especially if accompanied by other symptoms like conjunctivitis and urethritis.
- Other Likely diagnoses
- Dyshidrotic eczema: This is a type of eczema that presents with small, itchy blisters or papules on the hands and feet. It's a common condition that could easily explain red papules on the hands.
- Psoriasis: Psoriasis can cause red, scaly patches on various parts of the body, including the hands. The appearance of red papules could be an early sign of psoriatic lesions.
- Contact dermatitis: This is a skin reaction that occurs after contact with an irritant or allergen, leading to redness, itching, and small papules. Given the hands' frequent exposure to various substances, contact dermatitis is a plausible explanation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Erythema multiforme: A skin condition characterized by target lesions, which can sometimes appear as red papules. It can be associated with infections or medications and, in severe cases, can lead to life-threatening conditions like Stevens-Johnson syndrome.
- Vasculitis: Certain types of vasculitis, like leukocytoclastic vasculitis, can present with red papules on the skin. Vasculitis can be associated with serious systemic diseases and requires prompt diagnosis and treatment.
- Rare diagnoses
- Sarcoidosis: A condition that can cause skin lesions, including papules, due to the formation of granulomas in various parts of the body. While less common, sarcoidosis should be considered in the differential diagnosis, especially if other systemic symptoms are present.
- Pityriasis rubra pilaris: A rare skin disorder characterized by the formation of reddish-orange patches and papules. It's an uncommon condition but should be kept in mind when evaluating red papules on the hands, especially if accompanied by other characteristic features like palmoplantar keratoderma.