Differential Diagnosis for Eczematous Eruption with Nodular Prurigo and Milia on Dorsum of Hands
- Single Most Likely Diagnosis
- Atopic Dermatitis: This condition is characterized by eczematous eruptions and intense pruritus, which can lead to the development of nodular prurigo. The presence of milia, which are small, white bumps, can also be seen in atopic dermatitis due to the chronic scratching and skin barrier disruption.
- Other Likely Diagnoses
- Contact Dermatitis: This is a type of skin inflammation caused by contact with irritants or allergens, which could explain the eczematous eruption and nodular prurigo, especially if the patient has been exposed to new substances on their hands.
- Lichen Simplex Chronicus: A condition resulting from chronic scratching, leading to thickened skin, which could present with nodular prurigo-like lesions and is often associated with atopic dermatitis.
- Dry Skin (Xerosis): Severe dryness can lead to eczematous changes and pruritus, potentially resulting in nodular prurigo, especially in areas like the hands which are more prone to dryness.
- Do Not Miss Diagnoses
- Bullous Pemphigoid: An autoimmune blistering disease that can initially present with eczematous lesions and pruritus, making it crucial not to miss due to its potential for severe outcomes if not treated.
- Cutaneous T-Cell Lymphoma (Mycosis Fungoides): A rare form of skin cancer that can mimic various dermatoses, including eczematous eruptions, and is critical to diagnose early for effective management.
- Rare Diagnoses
- Hyper-IgE Syndrome (Job Syndrome): Characterized by recurrent cutaneous and pulmonary infections and extremely high levels of IgE, which can present with eczematous dermatitis.
- Netherton Syndrome: A rare genetic disorder featuring congenital ichthyosiform erythroderma, atopic-like dermatitis, and hair shaft abnormalities, which could be considered in severe, unexplained cases of eczematous eruption.
- Keratosis Pilaris: A condition that causes rough patches and small, acne-like bumps on the skin, often on the arms, thighs, cheeks, and buttocks, but can sometimes appear on the hands, potentially mimicking some features of the described condition.