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.