Female patient aged 35 years old, came to emergency room due to syncopal attack while walking in the street, she is conscious now but complaining of headche, blood pressure was measured but found with in normal range, no history of diabetes mellitus,
there is history of skin rashes which appear periodically all over the body, headche for 1 week, edema in both eye lids (but no history of urinary troubles) , trauma to Rt ear 1 week ago and the otolaryngist told her that the ear drum is torn and prescribed an antibiotic ,analgesic & follow up.
ON EXAMINATION : No skin rashes are present at that time , but there is evident bilateral equal periorbital edema!
What is the next step?
What are the possible causes of this edema?
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Is it sensitive skin or something else?