Hands and Feet Red Non Scaly

Red lesions on the hands and feet without overlying scale usually indicate a vasculitic process,annular erythemas or granuloma annulare.The latter is usually mistaken for a fungal infection(ringworm) but there is no overlying scale.It is all a dermal process.Vasculitis affecting the feet can give a variety of morphologies including erythematous patch,urticaria,erythema multiforme,palpable purpura,purpuric vesicles,blisters and ulcers.Erythema multiforme typically has iris lesions .Secondary syphilis has red brown macules on the palms and soles some of which are usually scaly.Straight palmar erythema can be a feature of underlying liver disease.Erythromelalgia gives red palms and soles with paroxysmal burning pain.

SIGN DIP MEN    Overview of Red Nonscaly Diseases

 

S-Squamous  Flexural or genital psoriasis 

 

I-Infective    Measles,Scarlet fever,Rubella,Infectious mononucleosis,Toxic shock syndrome,Staph scalded skin syndrome,Syphilis,HIV exanthem,Typhoid fever,Typhus,steroid modified tinea,Kawasaki's disease,

 

G-Granulomatous   Sarcoidosis,Rosacea

 

N-Neoplastic   Sezary syndrome,Flushing disorders such as Carcinoid syndrome or Phaeochromocytoma,Urticaria pigmentosum,Leukaemia and Lymphoma

 

D-Drugs    Any drug reaction,Mercury exanthem,Phototoxic drug reactions,Acral erythema of chemotherapy,

 

I-Immunological    Toxic epidermal necrolysis, Systemic lupus erythematosus,

 

P-Physical     Sunburn,Nappy rash,

 

M-Metabolic

 

E-Endocrine Palmar erythema of pregnancy

 

N-Nutritional

 

 

 

Erosions on the hand    See the section on hands and blisters.Because of trauma blisters break easily on the hands and present as erosions.Remember Porphyria cutanea tarda.