CLINICAL DIAGNOSTIC MANUAL
Itchy skin with lesions but without hives is a dermatological condition that may be associated with various inflammatory, infectious, and autoimmune diseases. Unlike pruritus accompanied by hives (such as in urticaria), these lesions can present as papules, plaques, vesicles, or scales. Identifying the underlying cause is crucial for effective treatment.
Pathology | Suspected Diagnosis | Confirmatory Diagnosis |
Allergic contact dermatitis | Redness and vesicles in areas exposed to allergens, intense itching. | Patch testing, physical examination. |
Candidiasis | White, moist plaques in warm, moist areas, itching, and redness. | Skin culture, KOH examination. |
Discoid eczema | Round, itchy plaques, dry and scaly skin. | Skin biopsy, physical examination. |
Drug-induced eczema | Skin rashes, itching, history of drug exposure. | Medical history, physical examination, allergy tests. |
Varicose eczema | Redness and itching in areas of venous insufficiency, varicose ulcers. | Venous Doppler ultrasound, physical examination. |
Scabies | Papules and vesicles, intense itching, especially at night. | Skin scraping, identification of mites. |
Seborrheic dermatitis | Greasy, yellowish plaques, itching, scaling in sebaceous areas. | Physical examination, skin biopsy. |
Asteatotic eczema | Dry, cracked skin, itching, more common in elderly individuals. | Physical examination, medical history. |
Dermatitis herpetiformis | Itchy vesicles, association with gluten enteropathy. | Skin biopsy, direct immunofluorescence. |
Lichen planus | Purple papules, intense itching, mucosal involvement. | Skin biopsy, physical examination. |
Psoriasis | Red plaques with silvery scales, itching, thickened skin. | Skin biopsy, physical examination. |
Eczema herpetiformis | Itchy vesicular lesions, history of atopic dermatitis. | Skin biopsy, physical examination. |
Lichen sclerosus | White, atrophic papules, intense itching. | Skin biopsy, physical examination. |
Lichen simplex chronicus | Thickened skin, intense itching, purple papules. | Skin biopsy, physical examination. |
Pellagra | Photosensitive dermatitis, diarrhea, dementia, associated with niacin deficiency. | Medical history, niacin level analysis. |
Polymorphous light eruption | Itchy lesions after sun exposure, vesicles, and papules. | Medical history, photoprovocation test. |
Pompholyx eczema | Itchy vesicles on hands and feet, exacerbated by stress. | Skin biopsy, physical examination. |
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