Differential Diagnosis for Red Hands

• Single most likely diagnosis
  • Erythema (skin redness) due to environmental factors: This is the most common cause of red hands, often resulting from exposure to cold temperatures, sunburn, or irritation from harsh chemicals or soaps. The redness is usually symmetric and may be accompanied by dryness or warmth of the skin.
• Other Likely diagnoses
  • Palmar erythema: A condition characterized by redness of the palms, often associated with liver disease, pregnancy, or thyroid disorders. It can also be a side effect of certain medications.
  • Contact dermatitis: An allergic or irritant reaction to substances that come into contact with the skin, leading to redness, itching, and sometimes blistering.
  • Psoriasis: A chronic skin condition that can cause red, scaly patches on the hands, among other areas of the body.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
  • Carbon monoxide poisoning: Although rare, carbon monoxide poisoning can cause cherry-red discoloration of the skin, including the hands, due to the binding of carbon monoxide to hemoglobin.
  • Sepsis: In severe cases of sepsis, especially if caused by certain bacteria like Neisseria meningitidis, a rash that can include red hands may appear. This condition is life-threatening and requires immediate medical attention.
• Rare diagnoses
  • Erythromelalgia: A disorder characterized by burning pain, heat, and redness in the hands and feet, often related to myeloproliferative disorders or as an idiopathic condition.
  • Raynaud's phenomenon: A condition that affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips, causing them to turn blue (and sometimes red as they recover) in response to cold or stress.