Recurring Hand Swelling and Itching: Possible Causes and Concerns

I have experienced itching and swelling in my palms five times within the past six months, and I am very concerned?

Hello, doctor.
I would like to ask about the swelling of my palms or fingers that has occurred five times in the past six months.
Is there something wrong with my body? Since I am currently abroad, I have to inquire online about the possible causes.
Before May 2016, I did not have these symptoms.
Between May 2016 and November 2016, I experienced this three times.
I have allergies on my face due to seasonal changes or exposure to seawater, so I did not pay much attention to it.
Each time it happened, I was outside.
The first three times, only one finger was swollen, and it would subside after about an hour.

On November 19, 2016, it was the most severe episode, where my entire palm swelled up significantly, resembling a pig's trotter.
Initially, at 6 PM, my right hand's fingers and palm, along with my left index finger (only the fleshy areas were swollen, and the joints were fine), began to swell.
Gradually, both hands became swollen, and when I made a fist, my skin felt very tight, with a slight warmth and mild itching in my palms.
I thought it was due to contact with something dirty, but washing my hands did not help.
By around 9:30 PM, the swelling was still present but had improved somewhat.
On December 24, 2016, at 8 PM, my hand started to swell again, with mild swelling, slight warmth, and no pain.
My hands are usually cold, and by around 8:30 or 9 PM, it returned to normal.
This time, the swelling was limited to my left palm (fingers were fine) and my right thumb (including the palm area near the thumb).
My left palm was itchy, while my right hand was just swollen.

Additionally, the day before, I noticed five mosquito bites on my foot.
Common factors include being outdoors, mild itching without pain during the swelling episodes.
In the last two occurrences, I had taken pain relievers (for sore throat or menstrual cramps).
I would like the doctor to help determine whether this is an issue with my immune system or simply an allergy or something like hives.
After researching online about immune system diseases, I am quite worried about the possibility of disability.

Winnie, 20~29 year old female. Ask Date: 2016/12/26

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
Based on your symptoms, it seems like you may be experiencing urticaria or angioedema, but a definitive diagnosis requires a physical examination and a detailed medical history.
I recommend taking photos of the swelling and then consulting with an allergist or immunologist.
The Changhua Hospital, Ministry of Health and Welfare, has a department for allergy, immunology, and rheumatology that can assist you.
Take care.

Reply Date: 2016/12/26

More Info

Recurring hand swelling and itching can be concerning, especially when it occurs multiple times within a short period. Based on your description, it seems that you have experienced episodes of swelling and itching in your hands, with varying severity and duration. Let's explore some possible causes and concerns related to your symptoms.

1. Allergic Reactions: Given that you mentioned experiencing swelling primarily when outdoors, it is possible that you are having allergic reactions to environmental factors. This could include allergens such as pollen, insect bites (as you noted with mosquito bites), or even contact with certain materials or substances. The fact that your symptoms sometimes coincide with exposure to the outdoors suggests that an allergic response could be a significant factor.

2. Angioedema: This condition involves swelling beneath the skin, often around the eyes and lips, but it can also affect the hands. Angioedema can be triggered by allergies, medications, or even stress. The swelling you described, particularly when it involves multiple fingers and the palm, could potentially be angioedema, especially if it resolves relatively quickly.

3. Urticaria (Hives): Urticaria is characterized by raised, itchy welts on the skin and can be triggered by various factors, including food, medications, or environmental allergens. The itching and the transient nature of your swelling could suggest that you might be experiencing hives, particularly if the swelling is accompanied by a rash.

4. Autoimmune Conditions: While less likely given the episodic nature of your symptoms, certain autoimmune diseases can cause swelling and skin reactions. Conditions such as lupus or rheumatoid arthritis can lead to joint swelling and skin issues. However, these conditions typically present with additional symptoms, such as joint pain or systemic symptoms (fatigue, fever).

5. Medication Reactions: You mentioned taking pain relievers during some of these episodes. Non-steroidal anti-inflammatory drugs (NSAIDs) can sometimes cause allergic reactions, leading to swelling and itching. If you notice a correlation between taking these medications and your symptoms, it would be wise to discuss this with a healthcare provider.

6. Insect Bites or Stings: Given that you experienced mosquito bites before some of the episodes, it is possible that the swelling is a localized reaction to insect bites. Insect bites can cause localized swelling, redness, and itching, which may resolve on their own.

Recommendations:
- Keep a Symptom Diary: Documenting when the swelling occurs, any potential triggers (foods, activities, medications), and the duration and severity of symptoms can help identify patterns and potential causes.

- Avoid Known Triggers: If you suspect certain allergens (like insect bites or specific plants) may be causing your symptoms, try to avoid them when possible.

- Consult a Healthcare Provider: Since your symptoms have been recurrent and concerning, it is essential to consult a healthcare provider for a thorough evaluation. They may recommend allergy testing, blood tests, or other diagnostic measures to determine the underlying cause of your symptoms.

- Consider Antihistamines: If your symptoms are related to allergies, over-the-counter antihistamines may help alleviate itching and swelling. However, consult with a healthcare provider before starting any new medication.

In conclusion, while your symptoms could be due to allergic reactions, they may also indicate other underlying issues. A healthcare professional can provide a more accurate diagnosis and appropriate treatment plan tailored to your specific situation. It is essential to address these symptoms promptly to ensure your health and well-being.

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