DIAGNOSIS CHECKLIST
for Face swelling

Why: to determine if acute or chronic.

Why: e.g. may get generalized facial swelling with obesity, allergic reactions, Cushing's syndrome, nephrotic syndrome, preeclampsia, hypoalbuminaemia, SVC thrombosis, Lassa fever, Chagus disease, trichinosis.

Why: may indicate possible allergic reaction.

Why: may indicate preeclampsia. Pregnancy increases the risk of cavernous sinus thrombosis.

Why: e.g. facial bone fracture and soft tissue injury to face may directly cause facial swelling; skull fracture may increase the risk of cavernous sinus thrombosis; facial burns may cause swelling.

Why: e.g. Nephrotic syndrome may be caused by systemic lupus erythematosus and diabetes; Dermatomyositis may often be associated with malignancy especially breast, lung, ovary, stomach, colon and uterus; Hypoalbuminemia (reduced albumin in the blood) may be due to chronic liver disease, malnutrition, nephrotic syndrome or protein losing bowel disease ( celiac disease, Crohn's disease, ulcerative colitis); superior vena caval obstruction may be due to lung cancer, large goiter or lymphoma; Cushing's syndrome; hypothyroidism may be associated with previous Grave's disease, rheumatoid arthritis, Down's syndrome or previous thyroid surgery.

Why: e.g. many medications such as penicillamine, high dose captopril and gold may cause nephrotic syndrome which can cause eyelid swelling; many medications may cause angioedema such as antibiotics especially penicillins, radiographic contrast agents, non-steroidal anti-inflammatory medications, ACE inhibitor antihypertensive medications, nifedipine, amiodarone, morphine, certain anti-cancer medications; oral contraceptive pill increases the risk of cavernous sinus thrombosis; Hypothyroidism may be caused by amiodarone and lithium.

Why: e.g. dust mite, mold, pollens; allergies may be associated with minimal change disease which is a cause of nephrotic syndrome.

Why: e.g. hereditary angioedema (C1 esterase inhibitor deficiency).

Why: e.g. West African trypanosomiasis found mainly in West Africa, Southern Sudan and Uganda may cause puffy face and puffy droopy eyelids; Lassa fever is confined to sub-Saharan West Africa and may cause swollen face; Trichinosis is found predominantly in the USA and Europe; Chagus' disease is confined to South and Central America.

Why: may indicate herpes zoster if rash is blister-like; red-purplish rash around the eyes may suggest dermatomyositis; hive-like rash suggest allergies, angioedema or anaphylaxis; acne-like facial rash may suggest rosacea.

Why: may indicate sinusitis, herpes zoster infection, orbital cellulitis, cavernous sinus thrombosis.

Why: may suggest allergies or blepharitis.

Why: may indicate sinusitis, orbital cellulitis, tooth abscess, mumps, trichinosis, Chagas' disease.

Why: e.g. purulent (pus-like) discharge usually indicates a bacterial infection; a clear watery or mucous discharge may suggest viral or allergic conjunctivitis.

Why: may indicate a tooth abscess with facial swelling.

Why: e.g. nasal blockage, facial pain and tenderness.

Why: e.g. facial swelling, especially around the eyes; swelling of the arms, genitals and sometimes abdomen; frothy urine.

Why: e.g. painful , tender, red, swelling of the lid, which after a few days localizes and cures itself spontaneously by discharging pus at the lash base.

Why: e.g. firm, non-tender lump in the lid. The lump may have a history of previous infection.

Why: e.g. eyelids have burning, itching and red margins, eyelashes may have crusting and scales, discharge or stickiness especially in the morning. If present for years there may be loss of eyelashes or distortion (in-growing) of the eyelashes. There may be a Staphylococcal bacterial infection which can cause severe inflammation with pus-like discharge.

Why: e.g. swelling and redness of the tear sac near the inner corner of the eye.

Why: e.g. pain, tingling and numbness around the eye may precede a blistering rash and eyelid swelling. Fifty percent of people have the eye itself affected with either corneal ulcers, episcleritis or iritis.

Why: e.g. flushing of the face with increases in skin temperature, acne-like rash over the face. May be complicated by blepharitis, conjunctivitis, episcleritis or corneal ulcers.

Why: e.g. pregnant woman with flashing lights seen in visual field, headache, generalized swelling of the face and legs, abdominal pain.

Why: e.g. red-purple rash with swelling around the eyes, progressive muscle weakness of the shoulder and thighs, difficulty in arising from sitting or laying position.

Why: e.g. hive like skin rash, facial swelling, itch, fatigue, headache, weakness, numbness of tongue, difficulty breathing if airway is affected.

Why: e.g. pain in the eye and forehead, proptosis (forward displacement of the eyeball), facial swelling, double vision due to weakness of the muscles that move the eye.

Why: e.g. early morning headache, facial swelling and blueness, swelling of the arms, distended neck and chest veins. May be due to lung cancer, lymphoma or large goiter.

Why: e.g. weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, depression, psychosis, insomnia, frequent urination, excessive thirst, growth arrest in children.

Why: e.g. husky voice, tiredness, weight gain, constipation, cold intolerance, loss of hair, puffiness of the eyes and face.

Why: e.g. watering eye, intense redness of the eye, scarring under the eyelids, ulcers on the surface of the eye, eyelid turn inwards and eyelashes scratch the surface of the eye. Trachoma is especially prevalent in outback areas and in aboriginal communities where hygiene may not be adequate.

Why: e.g. 24 hrs after the ingestion of contaminated meat may develop vomiting, diarrhea, abdominal pain and headache then may develop eyelid swelling, conjunctivitis, photophobia (dislike of eyes for light), fever, muscle pain and muscle spasm.

Why: e.g. red hard lump at the bite site, enlarged local lymph nodes. If the portal of entry is the conjunctiva, may get unilateral swelling of the eyelids, conjunctivitis and enlarged neck lymph nodes. May also have fever, transient rash and swelling of the face and trunk.