Facial swelling

Definition
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Polyätiologic, acute or chronic, diffuse or localized, red or skin-colored, painful or painless swelling of the face with or without general symptoms (e.g. fever or internal diseases).

Classification
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The differential diagnostic considerations can be structured according to the following algorithm:

Localization of the swelling (e.g. eyelid, cheek, lip, forehead)
Type of swelling:

localized
diffuse (evenly distributed).

Acute:

acute = < 6 weeks
chronic = > 6 weeks.

Color:

red
non-red.

Painfulness:

yes
no.

General symptoms:

e.g. fever, swelling of lymph nodes

e.g. acute or chronic internal diseases.

Clinical disease states or symptoms:

Diffuse, acute, red, facial swelling
Erysipelas
Initial Zoster
Initial or accompanying phenomenon in infectious exanthema (e.g. viral exanthema (see below Exanthema (DD)
Diagnostic symptom for erythema infectiosum (slap face)
Angioedema
hereditary angioedema
Diffuse, acute and/or chronic facial swelling in dermatomyositis or systemic scleroderma
Urticaria (acute)
Erythrophobia (Erythema e pudore)
Flush Phenomena
Contact allergic or toxic eczema of the face (also collateral in acute eczema of the capillitium e.g. after dyeing of the hair or after excessive UV exposure of the face).

Diffuse, chronic, red, facial swelling:

rosacea erythematosa
rosacea fulminans
acne conglobata
acne fulminans
Infant cutaneous hemangioma (swelling depending on the location; e.g. cheek, lip, eyelid)

Diffuse, acute and/or chronic facial swelling:

Dermatomyositis
systemic scleroderma
Erythema perstans faciei
M. Morbihan
Urticaria (chronic)
Edema in chronic alcoholism (see below alcohol, skin changes and ethylica facies)
Melkersson-Rosenthal syndrome.

Diffuse, acute/chronic, non-red, facial swelling:

Infant subcutaneous hemangioma (swelling depending on location; e.g. cheek, lip, eyelid)
Facial edema in nephritis and nephrosis (see also kidney diseases, skin changes)
Facial edema in chronic terminal renal failure
Facial edema with thyroid dysfunction
Plaque-like, cutaneous mucinosis (see below [ mucinosis(s)])
Facial edema due to influence congestion
Facies lunata as a symptom of Cushing's syndrome
Hunger Edema
Pseudoedema in facial nerve palsy
(Post-)Traumatic edema (persistent swelling after severe facial trauma)
Postoperative facial edema (persistent collateral swelling of the face after major flap plasty in the facial area).

"Thick cheek" (acute/chronic):

Swelling of the parotid gland of different aetiology (DD: diseases of the parotid gland)
Acute apical periodontitis (often with an avital tooth)
Dentitio difficile (difficult eruption of a wisdom tooth)
Root granulomas with fistula formation
Chronic osteomyelitis
Parulis
Emphysema (e.g. after dental treatment, e.g. by dry blowing a reamed root canal)
Fistula formation after lymph node tuberculosis
Actinomycosis (type of cervico-facial actinomycosis).

Swelling of the lips (acute/chronic):

Collateral lip swelling in aphthae of different aetiology
Herpes simplex labialis (see below Herpes simplex recidivans)
Lip Furuncle
cheilitis granulomatosa
Ashtray Syndrome
Chronic cheilitis glandularis
Tapir snout
Carcinoma, carcinoma of the lips.

Therapy
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Detection and elimination of the cause, if necessary careful internal or allergological clarification.
In case of morning swellings: cooling compresses, e.g. compresses soaked with black tea. Cool packs" are possible as an alternative.
For the therapy of eyelid swellings see there.