Acute Inflammatory Edema: A Frequently Overlooked Case of Pseudocellulitis

Hendra Gunawan, Dini Atiyah, Retno Hesty Maharani, Yogi Faldian, Ravika Khaila Arrum Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Hendra Gunawan, Department of Dermatology an...

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Main Authors: Gunawan H, Atiyah D, Maharani RH, Faldian Y, Arrum RK
Format: Article
Language:English
Published: Dove Medical Press 2025-03-01
Series:Clinical, Cosmetic and Investigational Dermatology
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Online Access:https://www.dovepress.com/acute-inflammatory-edema-a-frequently-overlooked-case-of-pseudocelluli-peer-reviewed-fulltext-article-CCID
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Summary:Hendra Gunawan, Dini Atiyah, Retno Hesty Maharani, Yogi Faldian, Ravika Khaila Arrum Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Hendra Gunawan, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +6281221111215, Email h.gunawan2016@unpad.ac.idAbstract: Pseudocellulitis is a non-necrotizing inflammation of the dermis and hypodermis with a non-infectious etiology. One of the variants of pseudocellulitis is acute inflammatory edema (AIE), characterized by bilateral, erythematous, and edematous plaques, often found in critically ill patients. AIE is a rarely reported and frequently overlooked case of pseudocellulitis. Therefore, it needs to be differentiated from classic cellulitis, which has different management and prognosis. This case report aimed to present a case of AIE in a critically ill patient. A 71-year-old woman was admitted to intensive care with reddish swelling on four extremities. She was suffering from sepsis caused by pneumonia, congestive heart failure, tubulointerstitial disease, and hypoalbuminemia. A physical examination showed bilateral erythematous and edematous plaques that palpably felt warm. ALT-70 score was 4, indicating not likely true cellulitis. The patient was diagnosed with AIE and treated with a compression bandage, diuretics, and medications for underlying diseases. The lesions improved significantly on the second day of evaluation; unfortunately, respiratory failure caused the patient’s death. Critically ill patients may have AIE misdiagnosed as cellulitis. Therefore, clinicians need to be well-versed in pseudocellulitis, especially AIE, to improve patient outcomes.Keywords: acute inflammatory edema, cellulitis, critical illness, pseudocellulitis
ISSN:1178-7015