Differential Diagnosis for 8y/o Rash
Single Most Likely Diagnosis
- Impetigo: A common, contagious skin infection that often starts on the hands and can spread to other areas, including the trunk. It's highly prevalent in children and matches the described pattern of spread.
Other Likely Diagnoses
- Eczema (Atopic Dermatitis): A chronic skin condition characterized by itchy, inflamed skin. It often starts in childhood and can begin on the hands before spreading to other areas, including the trunk.
- Contact Dermatitis: An allergic or irritant reaction that causes a rash, which can start on the hands if the child comes into contact with an allergen or irritant, and then spreads to the trunk if the exposure continues or if the child scratches the affected area.
- Tinea Infections (Ringworm): Fungal infections that can cause a rash on the skin. They are common in children and can start on the hands (tinea manuum) before spreading to the trunk (tinea corporis).
Do Not Miss Diagnoses
- Meningococcemia: A severe, life-threatening infection caused by Neisseria meningitidis. It can present with a rash that may start on the hands and feet and spread to the trunk. Although less common, it's critical to consider due to its high mortality rate if not promptly treated.
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Severe skin conditions usually caused by medications or infections. They can present with a rash and are medical emergencies due to the risk of significant morbidity and mortality.
Rare Diagnoses
- Kawasaki Disease: An acute febrile illness of childhood that can present with a rash, among other symptoms like fever, conjunctivitis, and lymphadenopathy. It's rare but important to consider due to its potential for cardiac complications.
- Pityriasis Rubra Pilaris: A rare skin disorder that can cause a rash starting on the hands and spreading to the trunk, accompanied by other characteristic skin findings like palmoplantar keratoderma.