Differential Diagnosis for Itching in the Hands and Feet
Single Most Likely Diagnosis
- Dry Skin (Xerosis): This is often the most common cause of itching in the hands and feet, especially in dry environments or during winter months. Itching is usually worse in areas with thick skin, such as the palms and soles.
Other Likely Diagnoses
- Atopic Dermatitis (Eczema): A chronic skin condition characterized by itchy, inflamed skin. It can affect any part of the body, including the hands and feet.
- Contact Dermatitis: An allergic or irritant reaction to substances that come into contact with the skin, leading to itching, redness, and small blisters.
- Psoriasis: A chronic autoimmune condition that speeds up the life cycle of skin cells, causing cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that itch and burn.
- Fungal Infections (e.g., Athlete's Foot): Fungal infections can cause itching, especially between the toes and on the soles of the feet.
Do Not Miss Diagnoses
- Lymphoma: Certain types of lymphoma, such as cutaneous T-cell lymphoma, can cause itching all over the body, including the hands and feet, without any visible skin lesions.
- Hodgkin's Disease: A type of lymphoma that can cause severe itching, especially if the disease has spread.
- Cholestasis: A condition where bile flow is reduced or blocked, leading to a buildup of bile salts in the blood, which can cause severe itching all over the body, including the hands and feet.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause itching, although the exact mechanism is not fully understood.
Rare Diagnoses
- Pityriasis Rubra Pilaris: A rare skin disorder that causes constant itching, scaling, and thickening of the skin, often affecting the hands and feet.
- Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, often accompanied by itching.
- Aquagenic Pruritus: A rare condition where contact with water causes intense itching without any visible skin lesions.
- Polycythemia Vera: A rare blood disorder that can cause itching, especially after warm baths or showers, due to the release of histamine from basophils.