Differential Diagnosis > Distribution > Acral > Hands and/or Feet > Dorsal Hands

Dorsal Hands

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• this location should prompt one to think of about photodistribution

 

 

Dermal:

•erythema elevatum diutinum
•granuloma annulare
•multicentric reticulohistiocytosis

 

Flesh-colored papules:

•colloid milium
•acrokeratosis verruciformis of Hopf
•acrokeratoelastoides of Costa
•focal acral hyperkeratosis resembles acrokeratoelastoidosis but shows no elastorrhexis on biopsy
•verruca plana
•epidermodysplasia verruciformis

 

Blisters:

•PCT vs. EBA (vs. EBS in children)

 

Other:

•paraneoplastic pemphigus (rare in PV)
•Gottron’s papules