Differential Diagnosis for a 2-year-old with Foot in Mouth and Blisters on Hands
- Single most likely diagnosis:
- Hand, Foot, and Mouth Disease (HFMD) - This is the most likely diagnosis due to the classic presentation of oral ulcers (often described as "foot in mouth" due to the location and appearance) and blisters on the hands, which are hallmark symptoms of HFMD, a common viral illness in children.
- Other Likely diagnoses:
- Herpetic Gingivostomatitis - This condition, caused by the herpes simplex virus, can present with oral ulcers and could potentially be accompanied by skin lesions on the hands if the child has scratched the herpetic lesions and then touched their hands.
- Impetigo - A bacterial skin infection that can cause blisters or sores on the hands and potentially around the mouth, though it less commonly causes oral ulcers.
- Do Not Miss diagnoses:
- Child Abuse - It's crucial to consider non-accidental injury, especially if the blisters or lesions have a pattern suggestive of burns or other inflicted injuries.
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis - Although rare, these severe skin and mucous membrane disorders can be life-threatening and require immediate medical attention. They can be caused by medications or infections.
- Rare diagnoses:
- Kawasaki Disease - An illness that affects children and causes fever, rash, swelling of hands and feet, and other symptoms. While it's rare, it's a significant condition because it can lead to cardiac complications if not treated promptly.
- Erythema Multiforme - A skin condition characterized by target lesions, which can sometimes appear on the hands and be accompanied by oral ulcers. It can be triggered by infections or medications.