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Differential Diagnosis for Rash on Hands, Feet, and Mouth

Single Most Likely Diagnosis

  • Hand, Foot, and Mouth Disease (HFMD): This is the most likely diagnosis given the symptoms of rash on hands, feet, and mouth, especially in a 12-year-old male. HFMD is a common viral illness in children, typically caused by coxsackievirus A or enterovirus 71, characterized by these specific symptoms.

Other Likely Diagnoses

  • Erythema Multiforme: This condition is characterized by target lesions on the skin and can also involve the mucous membranes, including the mouth. It can be triggered by infections or medications.
  • Kawasaki Disease: Although more common in younger children, Kawasaki disease can present with rash, fever, and oral changes, including redness of the mouth and throat.
  • Impetigo: A bacterial skin infection that can cause sores or blisters on the hands and feet, and can also involve the mouth area if scratched and infected.

Do Not Miss Diagnoses

  • Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN): These are severe skin and mucous membrane disorders, usually a reaction to medication or infection. They can present with skin lesions and mucous membrane involvement, similar to the described symptoms, but are much more severe and potentially life-threatening.
  • Meningococcemia: A severe infection caused by Neisseria meningitidis, which can present with a rash, but is distinguished by its rapid progression and severity, including potential for sepsis and meningitis.

Rare Diagnoses

  • Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes, which could potentially present with oral lesions and skin rash.
  • Paraneoplastic Pemphigus: A rare autoimmune disorder associated with underlying neoplasia, characterized by severe mucosal lesions and skin blistering.
  • Enteroviral Exanthem (other than HFMD): Other enteroviruses can cause rashes and systemic illnesses, though the specific pattern of hand, foot, and mouth involvement is more characteristic of HFMD.

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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