What are the differential diagnoses for unilateral or bilateral lower eyelid (periorbital) swelling?

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Differential Diagnosis for Lower Eyelid Swelling

Single Most Likely Diagnosis

  • Allergic Reaction: This is often the most common cause of lower eyelid swelling, typically presenting with itching, redness, and swelling due to an allergic response to substances like pollen, dust, or makeup.

Other Likely Diagnoses

  • Blepharitis: Inflammation of the eyelids, which can cause swelling, redness, and irritation, often associated with bacterial or demodex mite infestations.
  • Hordeolum (Stye): A localized infection or inflammation of the eyelid margin involving hair follicles of the eyelashes or meibomian glands, which can cause swelling and pain.
  • Chalazion: A small bump on the eyelid due to a blocked oil gland, which can cause swelling and may become inflamed or infected.
  • Eczema/Dermatitis: Skin conditions that can affect the eyelids, leading to swelling, itching, and redness.

Do Not Miss Diagnoses

  • Orbital Cellulitis: A serious infection of the tissues surrounding the eye, which can cause swelling, pain, and vision changes, requiring prompt antibiotic treatment.
  • Angioedema: A condition characterized by rapid swelling of the skin and mucous membranes, which can be life-threatening if it involves the airways.
  • Thyroid Eye Disease: A condition associated with Graves' disease, which can cause eyelid swelling, bulging eyes, and vision changes.

Rare Diagnoses

  • Sarcoidosis: A systemic disease that can cause inflammation and swelling in various parts of the body, including the eyelids.
  • Wegener's Granulomatosis: A rare autoimmune disorder that can cause inflammation and damage to blood vessels, including those in the eyes, leading to swelling and other symptoms.
  • Lymphoma: A type of cancer that can affect the eyelids and cause swelling, although this is extremely rare.
  • Xanthelasma: A condition characterized by small, yellowish patches or bumps on the eyelids due to lipid deposits, which can cause swelling but is usually benign.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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