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Severe facial swelling, rashes, light colored skin. Taken prednisone, hydroxizine. Treatment?

My 13-year-old son has severe facial swelling , with redness. He has no pain, no itching, no obvious swelling of lymph nodes or salivary glands, no irritation or discharge of the eyes or sinuses. He first showed what appeared to be a rash on Thursday morning, on his right cheek, just under his right eye, and on his nose, with slight swelling and lesser involvement on the left side. The rash was undifferentiated - no spots, no rings, no raised lumps . The one oddity was a small patch of crusty, lighter-colored skin high on the right cheek, which has since gone away. Basically, he looked like he d been hit in the face with a volleyball. By Friday morning, the swelling was so severe on the right side that he could barely open that eye, though it eased up a bit after he d been upright for a few hours. We took him to the doctor, who gave him prednisone and hydroxizine, but really had no idea what was causing it. She suggested poison ivy, which seemed absurd to me, since he has no itching or pain, and the rash wasn t spotty or lumpy. Today, the rash is a little abated, but the swelling is not. Still no pain and no itching.
Asked On : Tue, 31 Jul 2012
Answers:  1 Views:  166
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Dermatologist 's  Response
dear Richard, hello and welcome to HCM.
this is a difficult question to answer since you have said it is involving on side of face. by the history it seems to be an acute episode. the possibilities include acute angioedema, which can be localised and the other possibilities are contact allergy, or a sting. based on the discrition you have given it fits more into angioedema.pain may be absent here since the tissues around the eye take a lot of fluid since they have lax skin. before arriving at any diagnostic parameter it is essential to treat him for the acute episode. predinisolone and hydroxyzin. can combine with a ice packs to reduce the swelling. also it necessary to get an ophthalmologist to rule out any periorbital cellulitis. do get his blood pressure cheked and his urine for any protienuria,
it would be difficult to advise without a photogragh but we sincerly try to do our best.
thank ou take care and do contact if necessary.
will wait for your kind reply
thank you
dr satya
Answered: Fri, 3 Aug 2012
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