Diagnosis: Contact dermatitis allergic
Description: Marked facial oedema with little dermatitic reaction
Morphology: Swelling
Site: Face
Sex: F
Age: 27
Type: Clinical
Submitted By: Ian McColl
Differential Diagnosis
History:
| Patient of Dr Ebtisam Elghblawi A new bride 27 years old presented with a sudden history of swollen face with swollen itchy eyelids, redness at the right forehead, and nape of the neck. the histry started since few days when she went to the hair dressor and dyed her hair. O/E; both eyes swollen, The eyelids are however slighty closed (semi closed). area of erythema over the right forehead region. area of the nape of neck is red as well. all are red and not oozing. scalp is not red, not scaly. also both ears are swollen. also its clear that she is dying (bleaching her eyebrows which made her more sensitised and susciptable. Face as can be seen its disfigured (triangle disfigurment shaped). an arrangament for patch test has to be made afterwards to determine if there an allergy to PPD. Dg; contact allergic dermatitis/ hair dye dermatitis Advised to rinse throughly with copious water to remove any hair dye remanant, and wet dressing of cold olive oil. Managment given, a stat 100 mg hydrocortisone injection IM, and prednisolone tab 20 mg 1x1 for 5 days, local cetestoderm cream and anti histamine tablet SOS.
It is interesting that you mainly have oedema anteriorly but classic features of a dermatitis on the nape of the neck. Presumably the oedema fluid accumulates around her eyes spreading from the scalp. Sometimes if the hair is washed and the waste water and dye come in contact with the face the first signs of allergy will be on the thin eyelid skin. Presumably here the water has been washed off backwards. See Dermnet on PPD allergy (Submitted By: Dr Ian McColl)
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