Differential Diagnosis for a 58-year-old Female with a 3-day History of Hives
- Single Most Likely Diagnosis
- Acute Urticaria: This is the most common cause of hives in adults, often triggered by allergic reactions to foods, medications, or infections. The sudden onset and short duration of symptoms make this diagnosis likely.
- Other Likely Diagnoses
- Allergic Reaction to Medication: Given the patient's age, it's possible that a newly introduced medication could be the culprit behind the hives.
- Insect Bites or Stings: Reactions to insect bites or stings can cause hives and are common in individuals who spend time outdoors.
- Food Allergy: A food allergy could be the cause of the hives, especially if the patient has recently introduced new foods into their diet.
- Viral Infection: Certain viral infections, such as a cold or flu, can trigger hives in some individuals.
- Do Not Miss Diagnoses
- Anaphylaxis: Although the patient's symptoms have been present for 3 days, it's essential to consider anaphylaxis, a life-threatening allergic reaction that requires immediate medical attention.
- Mastocytosis: A rare condition characterized by an accumulation of mast cells in the skin, which can cause hives, among other symptoms.
- Autoimmune Disorders (e.g., Lupus, Rheumatoid Arthritis): Certain autoimmune disorders can cause hives, and it's crucial to consider these diagnoses to avoid missing a potentially serious underlying condition.
- Rare Diagnoses
- Urticarial Vasculitis: A rare condition characterized by inflammation of the blood vessels, which can cause hives, among other symptoms.
- Erythema Multiforme: A rare skin condition that can cause hives, blisters, and other skin lesions.
- Parasitic Infections (e.g., Scabies, Parasitic Worms): Certain parasitic infections can cause hives, although these are relatively rare in developed countries.