A 42-year-old woman presented with a 4-year history of recurrent attacks of angioedema, urticaria, and fever. She had severe itching and painful swelling of the upper part of her arms, which impaired normal movement. She also reported elevations of temperature (up to 39.8°C) and weight gain (up to 7 kg) during attacks, both of which normalized afterward.
Physical examination revealed bizarre erythematous, urticarial, and partially confluent angioedema involving the face, trunk, and extremities (Figure 1). A massive swelling of cervical and supraclavicular lymph nodes dominated the contour of the neck (Figure 2). A skin biopsy specimen was obtained from the upper arm (Figure 3).
Hehn J, Bröcker E, Goebeler M. Angioedema, Eosinophilia, and Fever—Quiz Case. Arch Dermatol. 2005;141(5):633-638. doi:10.1001/archderm.141.5.633-e