Differential Diagnosis for Swelling and Rash in a 32-year-old Female Patient

Given the patient's presentation of swelling on half of her face and a whole-body rash that is intermittent and has been ongoing for months, along with a history of stroke 3 months ago and a recent birth 8 months ago, the following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Postpartum Autoimmune Disorders: Conditions such as postpartum thyroiditis or other autoimmune disorders that could be triggered by pregnancy and childbirth. The recent birth and the onset of symptoms could be related, especially considering the autoimmune nature of some postpartum conditions.
• Other Likely Diagnoses
  • Cellulitis or Dermatitis: Given the swelling on one side of the face, cellulitis (a bacterial skin infection) or contact dermatitis could be considered, especially if there's a history of exposure to allergens or irritants.
  • Urticaria: Intermittent whole-body rash could suggest urticaria (hives), which can be caused by allergic reactions, infections, or autoimmune conditions.
  • Lupus or Other Connective Tissue Diseases: Although less common, systemic lupus erythematosus (SLE) or other connective tissue diseases could present with skin rashes and have been associated with an increased risk of stroke, which aligns with the patient's history.
• Do Not Miss Diagnoses
  • Vasculitis: Conditions like giant cell arteritis or other forms of vasculitis could explain both the facial swelling and the rash, and are critical to diagnose due to their potential for serious complications, including vision loss and organ damage.
  • Neurological Conditions: Given the patient's history of stroke, conditions that could cause neurological symptoms, including those that might manifest as facial swelling or rash (e.g., multiple sclerosis), should be considered.
  • Cancer: Although rare, certain types of cancer (like lymphoma) can cause rashes and should not be overlooked, especially in the context of recent significant medical events like a stroke.
• Rare Diagnoses
  • Sjögren's Syndrome: An autoimmune disorder that could cause skin rashes and has been associated with an increased risk of stroke.
  • Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues, which could potentially explain some of the patient's symptoms, including the stroke and skin manifestations.
  • Melasma or Other Dermatological Conditions: Although these would not typically cause swelling on one side of the face, they could contribute to the rash and should be considered in the differential diagnosis.

Each of these diagnoses requires careful consideration of the patient's history, physical examination, and potentially additional diagnostic tests to determine the underlying cause of her symptoms.