Differential Diagnosis for Itchy Rash and Swelling of Eyes and Face
- Single most likely diagnosis
- Allergic contact dermatitis: This is a common condition that can cause itchy rashes, especially on the hands, and can be followed by an allergic reaction that leads to swelling of the eyes and face. The progression from localized rash to facial swelling suggests an allergic response.
- Other Likely diagnoses
- Angioedema: This condition involves deep tissue swelling, often triggered by an allergic reaction, which can cause swelling of the eyes, face, and other areas. The rapid progression of swelling from one eye to both and then down the face is consistent with angioedema.
- Urticaria: Hives can cause itchy rashes and can be associated with angioedema, leading to swelling of the face and eyes. The itchy rash on the hands could be urticarial in nature.
- Eczema (atopic dermatitis): While primarily a skin condition, severe cases of eczema can lead to widespread reactions, including facial swelling, especially if there's an allergic component.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Anaphylaxis: Although the description does not fully meet the criteria for anaphylaxis (which typically includes symptoms such as difficulty breathing, rapid heartbeat, and a drop in blood pressure, in addition to skin and mucosal symptoms), any condition that involves significant swelling, especially of the face and eyes, should prompt consideration of anaphylaxis due to its life-threatening potential.
- Hereditary angioedema: A rare genetic disorder that can cause recurrent episodes of severe swelling, which can be life-threatening if not properly managed. The absence of itching and the severity of the swelling could suggest this diagnosis.
- Rare diagnoses
- Stevens-Johnson syndrome: A severe skin and mucous membrane disorder, usually a reaction to medication or infection, which can cause skin lesions, blisters, and swelling, including of the face and eyes. It's rare but serious and requires immediate medical attention.
- Dermatomyositis: An inflammatory disease characterized by skin rash and muscle weakness, which can sometimes present with facial swelling and rash, although this is less common.
- Sjögren's syndrome: An autoimmune disorder that can cause skin rashes, eye inflammation, and facial swelling, among other symptoms, though it's less likely to present acutely as described.