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Last updated: October 27, 2025View editorial policy

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Differential Diagnosis for Pustular Rash

  • Single most likely diagnosis
    • Acne vulgaris: This is the most common condition associated with a pustular rash, particularly in adolescents and young adults. It is characterized by comedones, papules, pustules, and sometimes cysts and nodules.
  • Other Likely diagnoses
    • Folliculitis: An inflammatory condition of the hair follicles, often caused by bacterial or fungal infections, leading to pustules around the hair follicles.
    • Impetigo: A highly contagious skin infection that can cause pustules, typically seen in children, caused by Staphylococcus aureus or Streptococcus pyogenes.
    • Pustular psoriasis: A rare type of psoriasis characterized by the widespread appearance of pustules, often accompanied by erythema and scaling.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Staphylococcal scalded skin syndrome (SSSS): A condition caused by staphylococcal toxins that can lead to widespread skin exfoliation and can be life-threatening, especially in infants and young children.
    • Toxic epidermal necrolysis (TEN): A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment, which can be fatal if not promptly treated.
    • Gonococcal infection: In sexually active individuals, a pustular rash could be a manifestation of a disseminated gonococcal infection, which requires immediate antibiotic treatment.
  • Rare diagnoses
    • Subcorneal pustular dermatosis: A rare skin condition characterized by the formation of pustules just beneath the stratum corneum, often associated with autoimmune disorders.
    • Acute generalized exanthematous pustulosis (AGEP): A rare skin condition usually triggered by medications or infections, characterized by numerous small pustules on a background of erythema.
    • Pustular dermatophytid: A rare condition associated with a fungal infection elsewhere in the body, leading to a pustular rash, often on the palms or soles.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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