What is the cause of a 65-year-old female's (f) painful and itchy, red, edematous, reticular rash that developed 2 hours after a nuclear medicine study of the gallbladder (galbladder) and has not improved over one week?

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Differential Diagnosis for 65 yo f with Red Edematous Reticular Rash

  • Single most likely diagnosis
    • Allergic reaction to contrast media: This is the most likely diagnosis given the temporal relationship between the nuclear medicine study and the onset of the rash. The rash appeared 2 hours after the study, which is a common time frame for an allergic reaction to contrast media.
  • Other Likely diagnoses
    • Contact dermatitis: Although less likely, contact dermatitis could be considered if the patient came into contact with an allergen or irritant during the nuclear medicine study.
    • Urticaria: Urticaria is a possible diagnosis given the itchy and painful nature of the rash, but it is less likely than an allergic reaction to contrast media.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Anaphylaxis: Although the patient does not have airway problems, anaphylaxis is a life-threatening condition that can progress rapidly. It is essential to consider this diagnosis, even if it seems unlikely.
    • Stevens-Johnson syndrome: This is a rare but life-threatening condition that can be triggered by an allergic reaction. It is crucial to monitor the patient for signs of Stevens-Johnson syndrome, such as mucosal involvement and skin necrosis.
  • Rare diagnoses
    • Erythema multiforme: This is a rare skin condition that can be triggered by an allergic reaction or infection. It is characterized by a distinctive target-like rash.
    • Serum sickness-like reaction: This is a rare condition that can occur after exposure to certain medications or contrast media. It is characterized by a rash, fever, and arthralgias.

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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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