Differential Diagnosis for Itching at Night with Excoriations between the Fingers
- Single most likely diagnosis:
- Atopic Dermatitis (Eczema): This condition is characterized by intense itching, especially at night, and can lead to excoriations due to scratching. The areas between the fingers are a common site for atopic dermatitis lesions.
- Other Likely diagnoses:
- Contact Dermatitis: Allergic or irritant contact dermatitis can cause itching and skin lesions, including between the fingers, due to exposure to allergens or irritants.
- Scabies: Caused by the mite Sarcoptes scabiei, scabies leads to severe itching, particularly at night, and can result in excoriations. The web spaces between the fingers are a typical location for scabies lesions.
- Dyshidrotic Eczema: This form of eczema is characterized by small, itchy blisters on the hands and feet, including the areas between the fingers.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Cutaneous T-Cell Lymphoma (Mycosis Fungoides): Although rare, this condition can present with itching and skin lesions. It's crucial to consider this diagnosis to avoid delayed treatment.
- Hypereosinophilic Syndrome: A group of disorders characterized by an overproduction of eosinophils, which can lead to itching and skin lesions.
- Rare diagnoses:
- Keratolysis Exfoliativa: A rare condition causing peeling of the skin on the palms and soles, which might be accompanied by itching.
- Pompholyx: A type of eczema that affects the hands and feet, characterized by small, itchy blisters.
- Acarodermatitis: Itching and skin lesions caused by an allergic reaction to the saliva or feces of mites in food or other products.