Differential Diagnosis for Flat Rash on Palms
- Single most likely diagnosis
- Dyshidrotic eczema: This condition is characterized by small, itchy blisters or a flat rash on the palms or soles, often associated with stress, allergies, or exposure to certain metals. It's a common condition that matches the description provided.
- Other Likely diagnoses
- Contact dermatitis: This is a type of inflammation of the skin that occurs when the skin comes into contact with an irritant or allergen, leading to a rash, which can be flat and appear on the palms.
- Psoriasis: While psoriasis more commonly affects the elbows, knees, and scalp, it can also cause a flat rash on the palms, especially in the form of palmoplantar psoriasis.
- Secondary syphilis: This condition can cause a variety of skin rashes, including a flat rash on the palms and soles, making it a consideration in the differential diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Syphilis (primary or secondary): Given the potential for serious complications if left untreated, including transmission to others or progression to tertiary syphilis, it's crucial not to miss this diagnosis.
- Pityriasis rubra pilaris: A rare skin disorder that can cause a flat rash and is associated with significant morbidity if not treated properly.
- Rare diagnoses
- Keratoderma blennorrhagicum: Associated with Reiter's syndrome, this condition causes a rash on the palms and soles but is less common.
- Pompholyx: A form of hand dermatitis that can present with a flat rash, though it's more commonly associated with vesicles.
- Mycosis fungoides: A rare form of cutaneous T-cell lymphoma that can initially present with skin lesions or rashes, including on the palms, though this would be an uncommon initial presentation.