Differential Diagnosis for Glove-like Distribution Finger Peeling

• Single most likely diagnosis
  • Kawasaki Disease: A condition that mainly affects children, causing inflammation in the walls of medium-sized arteries throughout the body. It often presents with fever, rash, swelling of the hands and feet, and peeling of the skin, particularly in a glove-like distribution on the fingers and toes.
• Other Likely diagnoses
  • Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins that typically affect infants and young children, leading to widespread skin peeling, resembling scalds. The peeling can sometimes appear in a glove-like distribution.
  • Toxic Epidermal Necrolysis (TEN): A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment, which can include the hands and feet, potentially presenting with a glove-like distribution of peeling.
  • Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes. While less common, it can lead to skin peeling, and in rare cases, might present with a distribution that could be described as glove-like.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Steven-Johnson Syndrome (SJS): A rare but serious disorder of the skin and mucous membranes, usually a reaction to medication or infection. It's characterized by skin necrosis and detachment, similar to TEN but less severe. Early recognition is crucial due to its potential for severe morbidity and mortality.
  • Erythema Multiforme: An immune-mediated disorder that can affect the skin and sometimes the mucous membranes, characterized by target lesions. While it's less likely to cause glove-like peeling, severe forms can lead to significant morbidity.
• Rare diagnoses
  • Peeling Skin Syndrome: A rare genetic disorder characterized by continuous shedding of the outer layer of the skin, which can sometimes present with a glove-like distribution of peeling.
  • Keratolysis Exfoliativa: A condition of the skin characterized by recurrent episodes of peeling of the skin of the palms and soles, which might occasionally resemble a glove-like distribution on the fingers.