Differential Diagnosis for Bilateral Palm Rashes/Swelling
Single Most Likely Diagnosis
- Dyshidrotic Eczema (Pompholyx): This condition is characterized by small, itchy blisters on the palms and soles, often due to allergies, stress, or environmental factors. It's a common cause of bilateral palm rashes and swelling.
Other Likely Diagnoses
- Contact Dermatitis: An allergic reaction or irritation from substances like soap, detergent, or certain metals can cause rashes and swelling on the palms.
- Psoriasis: Palmar psoriasis can lead to thick, scaly patches on the palms, sometimes accompanied by swelling.
- Eczema (Atopic Dermatitis): While more common in children, atopic dermatitis can also affect adults and may cause rashes and swelling on the palms.
- Tinea Manuum (Fungal Infection): A fungal infection of the palm, often caused by dermatophytes, leading to scaling, redness, and sometimes swelling.
Do Not Miss Diagnoses
- Scabies: A parasitic infection caused by the mite Sarcoptes scabiei, which can lead to severe itching and rash, including on the palms.
- Secondary Syphilis: A systemic infection that can cause a rash on the palms and soles, among other symptoms.
- Lyme Disease: In rare cases, Lyme disease can cause a rash on the palms, though it's more commonly associated with a distinctive "bull's-eye" rash.
Rare Diagnoses
- Keratoderma Blennorrhagicum: A rare condition associated with Reiter's syndrome, characterized by thick, scaly skin on the palms and soles.
- Palmoplantar Keratoderma: A group of rare genetic disorders leading to thickening of the skin on the palms and soles.
- Erythema Multiforme: An immune-mediated condition that can cause target-like lesions on the skin, including the palms, often in response to infections or medications.