Hand Dermatitis

Aka: Hand Dermatitis, Foot Dermatitis, Distal Extremity Rash, Acral Skin Lesion, Palm and Sole Desquamation, Palm and Sole Pustules, Palmoplantar Rash

1. See Also
   1. Nail-Related Growths
   2. Hand Infection
2. Causes: Itchy Blister
   1. Dyshidrotic Eczema
   2. Nummular Eczema
   3. Contact Dermatitis
   4. Tinea Manum and Tinea Pedis
   5. Insect Bite reaction
3. Causes: Erosion and excoriation
   1. Impetigo or super-infected dermatitis (most common)
      1. Treat with Dicloxacillin or Erythromycin x7-10 days
   2. Scabies
4. Causes: Blister becoming Pustule
   1. Eczematous Dermatitis
   2. Tinea Manum or Tinea Pedis
   3. Psoriasis
   4. Palmoplantar Pustulosis (Pustular Psoriasis)
5. Causes: Pustule
   1. Bacterial Infection (Most common)
      1. Staphylococcus aureus most common cause
   2. Fungi (dermatophytes, tinea)
   3. Psoriasis
   4. Old Blisters collecting debris
6. Causes: Solitary or scattered Pustules
   1. Bacterial Infection or Sepsis
      1. Consider NeisseriaGonorrhea, Candida
      2. Culture!
      3. Suspect Sepsis with Hemorrhagic Pustules
   2. Sporotrichosis
   3. Herpes simplex (Whitlow)
7. Causes: Scaly Papules and Plaques
   1. Psoriasis
   2. Secondary Syphilis
   3. Reiter's Syndrome
   4. Bowen's Disease (Squamous Cell Carcinoma In Situ)
   5. Discoid Lupus (scarring)
   6. Tinea does not usually present with multiple lesions
   7. Palmoplantar Pustulosis (Pustular Psoriasis)
8. Causes: Red palms and or soles with Generalized Rash
   1. Systemic Lupus Erythematosus
   2. Dermatomyositis
   3. Kawasaki Disease (followed by Desquamation)
   4. Liver disease
   5. Drug Eruption
   6. Viral Exanthem
9. Causes: Desquamation palms and soles
   1. Kawasaki Disease (late finding)
   2. Scarlet Fever
   3. Toxic Shock Syndrome
   4. Drug Eruption
   5. Dyshidrosis
   6. Mercury Poisoning
   7. Chikungunya
10. Causes: Pigmented lesions
    1. Acral Lentiginous Melanoma
    2. Racial trait
    3. Postinflammatory pigment
11. Causes: Painful palm and sole lesions
    1. Bacterial Endocarditis
       1. Osler Nodes (Painful raised lesions on palms and soles)
       2. Janeway Lesions (Painless hemorrhagic Nodules on palms or soles)
12. Causes: Miscellaneous Hand and Foot Dermatitis
    1. Photodermatitis
    2. Granuloma Annulare
    3. Raynaud's Syndrome
    4. Discoid Lupus
    5. Hyperhidrosis
    6. Vector-Borne Infection
       1. Dengue Fever
       2. Chikungunya