Differential Diagnosis for Hives and Swollen Hands and Mouth
Single Most Likely Diagnosis
- Acute Urticaria (Hives) with Angioedema: This condition is characterized by the sudden onset of hives and swelling, often triggered by an allergic reaction to food, medications, or insect bites. The symptoms described, such as hives, swollen hands, and mouth, are classic for this diagnosis.
Other Likely Diagnoses
- Allergic Contact Dermatitis: This is a type IV hypersensitivity reaction that occurs after exposure to an allergen, leading to skin inflammation and potentially systemic symptoms like hives and swelling.
- Food Allergy: An immune-mediated reaction to certain foods can cause hives, angioedema, and gastrointestinal symptoms.
- Insect Bite or Sting Allergy: Similar to food allergies, an allergic reaction to insect bites or stings can lead to localized or generalized symptoms including hives and swelling.
Do Not Miss Diagnoses
- Anaphylaxis: A severe, life-threatening allergic reaction that can cause hives, swelling, difficulty breathing, and a drop in blood pressure. It requires immediate medical attention.
- Hereditary Angioedema: A rare genetic disorder characterized by recurrent episodes of severe swelling, which can be life-threatening if not properly managed.
- Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A severe skin condition usually triggered by medications, leading to widespread skin necrosis and detachment, which can be fatal if not recognized and treated promptly.
Rare Diagnoses
- Mastocytosis: A condition characterized by the accumulation of mast cells in one or more organs, which can lead to episodes of hives, flushing, and swelling due to the release of histamine and other mediators.
- Erythema Multiforme: An immune-mediated skin condition that can cause target-like lesions and, in severe cases, mucosal involvement and systemic symptoms.
- Gleich's Syndrome (Eosinophilic Myalgia Syndrome): A rare condition associated with intense eosinophilia, myalgias, and sometimes skin manifestations like hives and swelling, often related to the ingestion of contaminated tryptophan supplements.