Make the Dx: Solution to 'New mom, new swelling'

By MDLinx staff
Published October 11, 2023
Nervous female patient with hands clasped and doctor pointing to tablet

Key Takeaways

Can you make the Dx?

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Several differential diagnoses are possible in this patient, such as allergic contact dermatitis, SLE, cheilitis granulomatosa, and hereditary angioedema (C1 inhibitor deficiency).

All of these can present with symptoms of facial/lip edema refractory to antihistamine, but only hereditary angioedema (C1 inhibitor deficiency) can be life-threatening. 

Allergic contact dermatitis is characterized by lesions in allergen-exposed areas, and the lesions are erythematous and scaly. Patients with SLE have discoid lesions and/or a malar rash—the predominant respiratory symptoms include pleuritis, pneumonitis, interstitial lung disease, and hemorrhage.

The major symptom associated with cheilitis granulomatosa is lip angioedema, but it is not associated with respiratory symptoms.

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