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 cheek swelling.....  



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Author3 Posts
  #1

An asymptomatic 3 y.o is brought to the physician becoz of rt.cheek swelling.The mother states that the pt. had been in his normal state of health until 1hr ago,when he developed rt. cheek swelling at a church picnic. Pt. is afebrile.Physical exam.....unremarkable xcept for rt. cheek, which is erythematous but not warmto touch.On palpation of the rt. cheek, mildly tender, dicrete,indurated masses r appreciated.Which of the following is the most likely cause of this child's problem?
1.Erysipelas
2.Cellulitis
3.Trauma
4.Panniculitis
5.Contact dermatitis




  #2

Erysipelas and Cellulitis is Staph produced disoder so lesion should be warm with demarcated line. There is no history of trauma, so I exlude choice 3. Also there is no signs of contact dematitis, so my answer is panniculitis.


  #3

ABSOLUTELY galad........I guess, this had to be ur answer after xclusion,right?(coz that's how i did it too).
Panniculitis.......secondary to cold injury to fat & is characterised by the development of indurated lesions that resemble buccal cellulitis.
Young children who hold popsicles in their mouths maybe prone to panniculitis.
Erysipelas........well demarcated,acute, pt. is ill looking, with fever, vomitings,irritability
No h/o trauma
Cellulitis......distinct margins, warm, tender, indurated
Contact dermatitis...erythematous/papulovesicular rash on xposure to contactant.
Good job galad.......... grin grin





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