Hello,
I am new to the forum. Please provide any tips that may help me with the undiagnosed condition I am facing. All details are below:
BASICS:
Age: 44
Sex: Male
Height: 6 ft
Weight: 190 lbs
Duration of complaint: 7 months
Location: NY
Existing relevant medical issues: None
Current medications: Finasteride 1 mg, once daily; Minoxidil 5%, 1 ml twice daily for androgenic alopecia; Ibuprofen 400-800 mg as needed for migraines.
SUMMARY:
-EPISODIC [12 episodes in 7 MONTHS; duration: 3 to 19 DAYS; gaps: 5 DAYS to 6 WEEKS] UNILATERAL [RIGHT] facial swelling involving VARIOUS areas of the RIGHT face in each episode:
- RIGHT CHEEK (starting from the bridge of the nose and expanding to the lower jaw) [Episode 1, 2, 3, 4, 7, 11]
- RIGHT UPPER-LIP [Episode 2]
- UNDER & LATERAL to the RIGHT EYE (eye-lid currently NOT involved) [Episode 4]
- RIGHT FOREHEAD around the EYEBROW (eye-lid currently NOT involved; though it is pushed down by the swelling above) [Episode 5]
- VERTICAL swelling on the RIGHT FOREHEAD, from nasal bridge approaching the hairline [Episode 5]
- HAIRLINE on the RIGHT FOREHEAD [Episode 6, 7]
- CHEWING MUSCLE of the RIGHT jaw in front of the ear [Episode 8, 9]
- RIGHT JAWLINE to the RIGHT of the chin [Episode 10]
- RIGHT side of the RIGHT corner of the lip [Episode 12]
- SELF-RESOLVING
-NO OTHER SYMPTOMS:
-- NO pain/tenderness, itchiness, erythema.
-- NO tingling/numbness/paralysis.
-- NO palpable hard mass
-- NO fever
-- NO headache
-- NO nasal congestion, runny nose or any other upper respiratory symptoms
-- NO troubled breathing, swallowing or eating
-- NO pain in gums or teeth while chewing or otherwise; the Dentist did not find anything remarkable during his evaluation, and read of panoramic dental x-rays.
-- NO fatigue
-- NO unintentional weight loss
-Visited 8 SPECIALISTS (PCP, Dentist, Oral Surgeon, Head & Neck, Ophthalmologist, Rheumatologist, Allergist, Dermatologist) across NYU Langone & Mount Sinai, NYC
-NO DIAGNOSIS yet
- NO TRIGGERS identified
- CT scan of sinuses, face MRI, dental panoramic X-rays, and blood & urine work has NOT revealed anything conclusive
- ANTIHISTAMINE (Allegra) & ANTIBIOTIC (Augmentin) treatments have NOT worked
TREATMENTS TRIED (without any noticeable effect):
- 10-day course of oral antibiotic Augmentin
- Zyrtec, Benadryl, Allegra
- Flonase
- Ibuprofen & Asprin
- Heat & Ice
HISTORY:
- NO PERSONAL or FAMILY history of allergies or angioedema; no exposure to new foods or chemicals; no travel. Moreover, Zyrtec, Benadryl, Allegra, and Flonase did not *seem* to improve symptoms
- NO PERSONAL history of sinusitis
- NO change in medication
- NO trauma
AUTO-IMMUNE:
- FAMILY HISTORY of auto-immune: [Vitiligo (Mom & both maternal grandparents), Grave's disease (maternal uncle), Diabetes (mom), Alzheimer's (maternal grandmother) etc]
- PERSONAL HISTORY of auto-immune: Alopecia Areata since 2017
CANCER:
- FAMILY HISTORY of cancer: Maternal aunt died of Lymphoma
- NO PERSONAL HISTORY w/ cancer
RECENT VACCINATIONS:
- COVID-19 (Moderna) - April 2021, May 2021, Nov 2021
- Tdap - Sept 2021
- Flu - Oct 2021
- HPV - Sept 2021, Oct 2021