Hey #MedTwitter !
1. What does the image show?
2. Possible etiologies?
#RheumTwitter
It's a purpuric rash. The two most important DDs are:
🔹Small vessel vasculitis (lupus, ANCA, cryoglobulinemia etc) ♨️
🔹Infective endocarditis (janeway lesions) ❣️
Bleeding disorders often affect areas where the skin is soft and loose rather than the soles
Other causes of palmoplantar rash
1️⃣Infections- maculopapular, blanching
🔹Viral eg parvovirus, coxsackie, measles
🔹Bacterial- menigococcimia (purpuric, non blanching), syphilis (2°)
🔹Rickettsia- RMSF
#MedTwitter #MedEd
2️⃣ Erythema Multiforme
Macular targetoid lesions- immune phenomenon secondary to infections (herpes simplex, mycoplasma) or drugs
3️⃣ Psoriasiform
Scaly erythematous plaques
🔹 Palmoplantar psoriasis
🔹Keratoderma blenorrhagicum
Both are clinically indistinguishable
🔹Other cause of a nodular scaly rash is arsenic keratosis
4️⃣ Palmar Erythema
Kawasaki's disease, CLD, pregnancy etc
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