9 Rashes That Affect the Palms and Soles

9 Rashes That Affect the Palms and Soles

The following are nine disease processes that cause a rash which affects the palms of the hands and soles of the feet


1. Coxsackie (hand Foot & Mouth) Vesicular lesions on a reddened base on hands , feet and buttocks
2. Rocky Mountain Spotted Fever (especially of wrist) Most often the rash begins as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles. These spots turn pale when pressure is applied and eventually become raised on the skin. The characteristic red, spotted (petechial) rash of Rocky Mountain Spotted Fever is usually not seen until the sixth day or later after onset of symptoms, but this type of rash occurs in only 35 to 60 percent of patients with Rocky Mountain spotted fever. The rash involves the palms or soles in as many as 80 percent of the patients. However, this distribution may not occur until later on in the course of the disease. As many as 15 percent of patients may never develop a rash.
3. Syphilis (secondary) During the secondary stage, may have skin rashes and/or sores in mouth, vagina, or anus.  The rash appears as rough, red, or reddish brown spots on the palms of the hands and/or the bottoms of the feet. The rash usually won’t itch and it is sometimes so faint that it is easily missed.
4. Janeway Lesions of bacterial endocarditis Non-tender, small erythematous or hemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are indicative of infective endocarditis. Janeway lesions are cutaneous evidence of septic emboli
5. Kawasaki Disease In the acute phase of the disease, changes in the peripheral extremities can include erythema of the palms and soles, which is often striking with sharp demarcation and often accompanied by painful, brawny edema of the dorsa of the hands or feet. This is why affected children frequently refuse to hold objects in their hands or to bear weight on their feet. Later, during the convalescent or the subacute phase, desquamation of the fingers and toes usually begins in the periungual region within two to three weeks after the onset of fever and may extend to include the palms and soles
6. Measles  Morbilliform maculopapular, brick-red rash on face beginning at hairline then progressing to palms and soles last - rash lasts 7 days
7. Toxic Shock Syndrome The staphylococcal TSS rash is more likely to desquamate, particularly on the palms and soles, between 3 and 7 days after onset.
8. Reactive Arthritis A small percentage of men and women develop small hard nodules called keratoderma blennorrhagicum on the soles of the feet and, less commonly, on the palms of the hands or elsewhere
9. Meningococcemia Petechiae (rash of small red or purple spots [purpura] that do not disappear when pressure is applied to the skin) occur in 50-75% of cases

The Daily PANCE and PANRE

Get 60 days of PANCE and PANRE Multiple Choice Board Review Questions delivered daily to your inbox. It's 100% FREE and 100% Awesome!

You have Successfully Subscribed!