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Allergic contact dermatitis

An intensely pruritic, vesicular rash in a pattern that suggests contact with an allergen, such as nickel on the palm from a tool handle or a ring on a finger.

Atopic dermatiis

A common cause of hand eczema, presenting with pruritus, erythema, scaling, and lichenification, often on the dorsal aspects and wrists.

Contact dermatitis

The most common cause of hand rash, presenting as dryness, scaling, and painful fissures from repeated exposure to irritants like water and detergents.

Dermatomyositis

An autoimmune disease with characteristic Gottron's papules (violaceous, scaly papules over the knuckles) and periungual telangiectasias.

Dyshidrotic eczema

A specific type of hand eczema characterized by an eruption of small, deep-seated, intensely itchy, "tapioca-like" vesicles on the palms and sides of fingers.

Erythema multiforme

An acute hypersensitivity reaction causing characteristic "target" or iris lesions, which have a predilection for the palms and dorsal hands.

Hand foot and mouth disease

A common viral illness in children causing oral ulcers and a rash of oval-shaped vesicles on the palms and dorsal hands.

Irritant dermatitis

A non-allergic reaction causing dryness, erythema, scaling, and fissuring, particularly on the dorsal hands, due to damage to the skin barrier.

Polymorphic light eruption

A common photodermatosis presenting as an itchy eruption of papules, plaques, or vesicles on sun-exposed skin, including the backs of the hands.

Psoriasis

Can present as well-demarcated, erythematous plaques with a thick, silvery scale (plaque psoriasis) or as sterile pustules (pustular psoriasis) on the palms.

Tinea manuum

A fungal infection of the hand, often presenting as unilateral, diffuse, fine scaling and hyperkeratosis in the palmar creases ("one hand, two feet" syndrome).

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