Angiœdème : diagnostics différentiels

One of the Faces of Facial Swelling: Melkersson-Rosenthal Syndrome

“…A few days after beginning treatment, she presented generalized itchy rash, mainly on her legs, which resolved with antihistamines and withdrawal of cotrimoxazole. For this reason, the patient was referred to our allergy department, where skin prick tests were performed with trimethoprim at 32 mg/mL and sulfamethoxazole at 200 mg/mL (Almofarma SL) and intradermal tests at 0.001 mg/mL of trimethoprim and 20 mg/mL of sulfamethoxazole, as previously reported [3]. The results were negative.…”

“…Angioedema is a self-limiting, localized swelling caused by increased vascular permeability that involves subcutaneous tissues and/or mucosa. MRS is an entity where swelling is also present [3].…”

“…According to Launay et al [3], during the recurrent edema phase, the syndrome may be misdiagnosed as angioedema. When edema becomes permanent or lasts more than 7 days, a diagnosis of MRS should be considered.…”

“…Sulfonamides are the most common culprits of adverse reactions to cotrimoxazole [2]. The prevalence of adverse reactions to cotrimoxazole ranges from 20% to 100% in certain populations, such as HIV-infected patients, while in healthy individuals the prevalence is normally between 5% and 8% [3]. The 2 possible therapeutic approaches following confirmed diagnosis of adverse reactions to cotrimoxazole are withdrawal of the drug and desensitization.…”