What is the cause of a skin condition on the palm of the hand resulting in loss of nails (onycholysis) and yellowing of the skin (jaundice)?

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Differential Diagnosis for Skin Condition of Palm of Hand

Single Most Likely Diagnosis

  • Psoriasis: This is a common skin condition that can cause thickening and yellowing of the skin on the palms, leading to nail loss. The symptoms described, such as loss of nails and yellowing of the palm, are consistent with palmoplantar psoriasis.

Other Likely Diagnoses

  • Eczema (Dyshidrotic): Characterized by small, itchy blisters on the palms, which can lead to skin thickening and potentially affect the nails. The yellowing could be due to secondary infection or chronic inflammation.
  • Palmoplantar Keratoderma: A group of disorders that cause thickening of the skin on the palms and soles, which can lead to nail changes, including loss.
  • Fungal Infections: Such as onychomycosis (fungal infection of the nails) and tinea manuum (fungal infection of the hand), which can cause nail loss and skin changes, including yellowing.

Do Not Miss Diagnoses

  • Squamous Cell Carcinoma: Although rare, skin cancers can present with unusual skin changes and nail loss. It's crucial to consider this diagnosis to ensure timely treatment if present.
  • Syphilis: Secondary syphilis can cause a variety of skin rashes, including on the palms, and can lead to nail changes. Missing this diagnosis could have significant health implications.
  • Lichen Planus: An inflammatory condition that can affect the skin and nails, leading to nail loss. It's less common but important to diagnose due to its potential to affect other areas, including the mouth and genitals.

Rare Diagnoses

  • Keratoderma Blennorrhagicum: Associated with Reiter's syndrome, this condition causes thickening and yellowing of the skin on the palms and soles, along with nail changes.
  • Pachyonychia Congenita: A rare genetic disorder that affects the nails and skin, leading to thickening of the skin on the palms and soles and nail abnormalities.
  • Yellow Nail Syndrome: A rare condition characterized by yellowing and thickening of the nails, which can be associated with lymphedema and respiratory issues. Skin changes on the palms can occur but are less common.

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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