Differential Diagnosis for Blister on Hand, Feet, and Mouth
- Single most likely diagnosis:
- Hand, Foot, and Mouth Disease (HFMD): This is the most likely diagnosis due to the characteristic presentation of blisters on the hands, feet, and mouth, commonly seen in children. It is usually caused by coxsackievirus A or enterovirus 71.
- Other Likely diagnoses:
- Herpangina: Similar to HFMD, herpangina is caused by coxsackieviruses and presents with mouth blisters, but it less commonly affects the hands and feet.
- Eczema Coxsackium (Eczema Herpeticum): A spread of herpes simplex virus within an area of eczema, which can cause blisters on the hands and feet if the eczema is present in these areas.
- Impetigo: A bacterial infection that can cause blisters on the hands and feet, though it less commonly affects the mouth.
- Do Not Miss diagnoses:
- Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN): Although rare, these are life-threatening conditions that can present with blisters and skin peeling, often due to a drug reaction. Early recognition is crucial.
- Staphylococcal Scalded Skin Syndrome (SSSS): Caused by staphylococcal toxins, SSSS can present with widespread blistering and peeling skin, which can be fatal if not promptly treated.
- Rare diagnoses:
- Pemphigus: An autoimmune disease that causes blistering of the skin and mucous membranes, which could potentially involve the hands, feet, and mouth.
- Epidermolysis Bullosa: A group of genetic conditions that result in fragile skin and blisters, which could be exacerbated by minor trauma to the hands, feet, and mouth.
- Kawasaki Disease: Although primarily known for its fever, rash, and lymph node involvement, Kawasaki disease can occasionally present with oral mucosal changes and might rarely cause blister-like lesions on the hands and feet.