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Angioedema

Presents as acute, well-demarcated, non-pitting swelling of the deep dermis and subcutaneous tissues, particularly affecting the lips, tongue, and periorbital region.

Angiosarcoma

An aggressive vascular malignancy, often on the scalp and face of the elderly, that can present as a poorly defined, expanding, bruise-like patch with significant edema.

Dermatomyositis

An autoimmune disease that causes a characteristic heliotrope rash (violaceous erythema) and edema of the upper eyelids.

Lepromatous leprosy

Infiltration of the facial skin by Mycobacterium leprae leads to diffuse thickening, nodules, and a characteristic "leonine facies" (lion-like face).

Lupus

Acute cutaneous lupus can present with the classic erythematous "butterfly rash" over the cheeks and nose, which may be edematous.

Melkersson-Rosenthal syndrome

A rare neurologic disorder with a classic triad of recurrent facial paralysis, fissured tongue, and persistent, non-pitting swelling of the lips (cheilitis granulomatosa).

Myxedema

Severe hypothyroidism causes deposition of mucopolysaccharides in the dermis, leading to a characteristic puffy, swollen face with coarse features and non-pitting edema.

Pachydermoperiostitis

A rare hereditary syndrome with skin thickening and furrowing of the face and scalp (cutis verticis gyrata), clubbing of the fingers, and periostosis.

Rosacea

Severe, persistent rosacea can lead to solid facial edema (Morbihan disease), a hard, non-pitting swelling of the upper two-thirds of the face.

Sarcoidosis

Can cause infiltrated plaques and nodules on the face, and a specific variant called lupus pernio presents as violaceous, swollen plaques on the nose, cheeks, and ears.

Scleromyxedema

A rare mucinosis associated with a monoclonal gammopathy, causing widespread waxy papules and a diffuse, woody induration and thickening of the facial skin.

Self-healing cutaneous mucinoses

A rare condition in infants with sudden onset of multiple subcutaneous nodules on the face and scalp that resolve spontaneously.

Still's disease

Adult-onset Still's disease can cause a characteristic evanescent, salmon-pink rash, but also sometimes periorbital edema along with fever and arthritis.

Superior vena cava syndrome

Obstruction of the superior vena cava leads to venous congestion, causing facial swelling (plethora), cyanosis, and distended neck veins.

Sweet's syndrome

Presents with abrupt onset of tender, edematous, erythematous plaques and nodules, which can be prominent on the face.

Systemic amyloidosis

Infiltration of the skin with amyloid can cause waxy thickening and easy bruising, particularly periorbital "pinch purpura".

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