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Pt had fever 2 -3 days back then appear itching reddish rash over both palm with pain

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fever AND palmar rash

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CDC fever rash palms hand foot mouth disease warning signs

A fever followed by a painful, red rash on both palms needs an in-person clinical assessment, preferably today, especially if the patient is a child, pregnant, immunocompromised, or appears unwell.
Possible causes include:
  • Hand-foot-and-mouth disease: fever followed by red spots or small blisters on palms/soles, often with mouth ulcers. It is common in children but adults can get it. The rash is usually not very itchy, though it can be tender. See CDC HFMD symptoms.
  • Erythema multiforme: symmetric painful/itchy lesions on hands, sometimes with characteristic target-like circles, often after an infection or medication.
  • Drug-related rash or contact dermatitis, if there was a new medicine, antibiotic, painkiller, soap, sanitizer, glove, or chemical exposure.
  • Less commonly, infections that can cause rash on palms, including rickettsial illness or dengue depending on local area and exposures.
Go to urgent care/emergency now if any of these are present:
  • Fever returning or persistent high fever
  • Rash that is purple/dark, does not fade when pressed, rapidly spreading, or forms blisters/skin peeling
  • Mouth, eye, or genital sores
  • Facial/lip swelling, wheeze, breathing difficulty
  • Severe headache, neck stiffness, confusion, marked weakness
  • Vomiting, poor drinking, reduced urine, dizziness
  • Recent new medication, particularly antibiotics or anti-seizure medicines
Until reviewed:
  • Keep the area clean, avoid scratching and new creams/medications.
  • Use paracetamol/acetaminophen for pain or fever if normally safe for the patient.
  • Avoid aspirin in children. If dengue is a possibility locally, avoid ibuprofen/aspirin until a clinician advises otherwise.
  • Check for mouth ulcers, blisters on feet, target-shaped spots, non-fading purple spots, and any recent medication or sick-contact exposure.
Please share the patient’s age, whether there are mouth sores or foot rash, whether lesions are blisters or target-shaped, and whether there was any new medicine or recent infection.
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