A 42-year-old man was seen in the clinic because of pain and redness in his finger. Last week he had injured the finger while working in his garage. On physical examination, there is erythema, swelling, and tenderness of the second digit in the right hand. Flexion and extension of the finger were normal. A clinical diagnose of cellulitis is made and he is prescribed cephalexin. A few days later he presents to the emergency room complaining of difficulty breathing. He has angioedema due to a drug reaction to the cephalexin. Which of the following physical findings is characteristic of this syndrome?
Unlike other causes of edema, angioedema is not dependent and can involve all epidermal and submucosal surfaces, although the lips, tongue, eyelids, genitalia, hands, and feet are the most commonly involved. Angioedema is often not itchy and, like urticaria, is transient; manifestation peaks in minutes to hours and disappears over hours to days. The fluid extravasates from deeper areas such as dermal and subdermal sites.
invariably severe itching
prolonged nature of the edema
fluid extravasation from subcutaneous and intradermal postcapillary venules
involvement of lips, tongue, eyelids, genitalia, and dorsum of hands or feet
Immunology and Rheumatology