Differential Diagnosis for Itchy Red Rash on Elbow
- Single most likely diagnosis
- Contact Dermatitis: The patient's history of wrestling and use of Bactroban (mupirocin) in the past for a similar rash suggests a possible allergic reaction or irritation from mats, equipment, or other substances encountered during wrestling. The itchy red rash on the elbow, resembling red welts, is consistent with contact dermatitis.
- Other Likely diagnoses
- Tinea Corporis (Ringworm): Given the patient's involvement in wrestling, a sport known for its risk of fungal infections, tinea corporis is a plausible diagnosis. The rash's appearance as red welts could be consistent with the early stages of ringworm.
- Impetigo: Although the patient has used Bactroban in the past, which is effective against impetigo, the current rash could still be impetigo, especially if the previous infection was not fully cleared or if the patient was re-exposed to the bacteria.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Methicillin-Resistant Staphylococcus aureus (MRSA) Infection: MRSA infections can present with skin lesions similar to those described and are a significant concern in athletes involved in contact sports like wrestling. Missing this diagnosis could lead to severe consequences, including sepsis.
- Herpes Simplex Virus (HSV) Infection: HSV can cause herpetic lesions that might resemble red welts, especially in the initial stages. HSV infections in wrestlers can be particularly problematic due to the risk of transmission to other athletes.
- Rare diagnoses
- Scabies: While less common in this context, scabies could present with itchy red lesions and should be considered, especially if the patient has been in close contact with someone infected.
- Erythema Multiforme: This is an immune-mediated condition that can cause skin lesions, including target lesions or red welts, often in response to infections or medications. It is less likely but should be kept in mind due to its potential severity.