[45M] Experiencing severe itching and swelling in hands and arms

Patient Description

A 45-year-old male reports severe itching and swelling in both hands, which began two nights ago and has now progressed to include the entire left hand, wrist, and is spreading up the arms. The affected areas are red, hot to the touch, and the swelling is significant enough to prevent hand closure. The patient has tried various remedies including allergy pills, Benadryl cream, hydrocortisone cream, and cold water rinses without relief. The patient also notes new onset itching in the knees. There is no fever, chills, shortness of breath, chest tightness, or pus/drainage. The patient has no known allergies, no adverse reactions to medications, and is not on any medications. The patient mentioned contact with old wood and a recent hospital visit as potential exposures. No pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Allergic Contact Dermatitis: This is a type of skin inflammation caused by direct contact with an allergen. This reaction can cause severe itching, redness, and swelling. It's possible that you came into contact with something you're allergic to, such as the old wood you mentioned.

    • Treatment usually involves avoiding the allergen and applying topical creams to relieve the symptoms.
  • Cellulitis: This is a common bacterial skin infection that can cause redness, swelling, and warmth in the affected area. It typically occurs when bacteria enter a break in the skin and spread. The fact that you were recently at a hospital could potentially increase the risk of exposure to bacteria.

    • Treatment typically involves antibiotics to kill the bacteria.
  • Hives (Urticaria): These are red, itchy welts that can appear suddenly and spread rapidly. They are usually an allergic reaction to food or medicine, but can also be triggered by other substances or physical factors.

    • Treatment usually involves antihistamines to control the itching.

What you can do

  1. Seek immediate medical attention. The spreading nature of your symptoms is concerning and should be evaluated by a healthcare professional as soon as possible.
  2. In the meantime, continue to avoid scratching the affected areas as this can worsen the condition and potentially lead to infection.
  3. Over-the-counter antihistamines may help to reduce the itching, but they are not a substitute for medical evaluation and treatment.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Rapid spread of the redness and swelling
  • Fever, chills, or feeling generally unwell
  • Increasing pain in the affected areas
  • Any difficulty breathing or swallowing

Please remember, while I strive to provide accurate information, I'm an AI and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

People Also Ask


What are the common causes of allergic contact dermatitis?

Allergic contact dermatitis is commonly caused by exposure to substances like poison ivy, nickel, fragrances, preservatives, and certain chemicals found in cosmetics or cleaning products. In this case, contact with old wood could be a potential allergen.


How can cellulitis be distinguished from other skin conditions?

Cellulitis can be distinguished from other skin conditions by its rapid onset of redness, swelling, warmth, and tenderness in the affected area. It often occurs after a break in the skin and can be accompanied by fever and chills, which are not typical of allergic reactions.


What are the typical treatments for hives (urticaria)?

Typical treatments for hives include antihistamines to reduce itching and swelling. In more severe cases, corticosteroids or other medications may be prescribed. Avoiding known triggers is also important in managing hives.


When should I seek medical attention for skin swelling and redness?

You should seek medical attention for skin swelling and redness if the symptoms are rapidly spreading, if you develop a fever or chills, if the pain increases, or if you experience difficulty breathing or swallowing, as these could indicate a more serious condition.


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