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An overview of angioedema

INTRODUCTION

Angioedema is self-limited, localized swelling of the skin, which results from extravasation of fluid into interstitial tissues. Angioedema affects the skin and mucosal tissues of the face, lips, mouth, and throat, larynx, extremities, and genitalia, often in an asymmetric pattern. Bowel wall involvement presents as colicky abdominal pain. Angioedema may occur in isolation, accompanied by urticaria, or as a component of anaphylaxis.

This topic review will present an overview of the clinical features, pathogenesis, etiologies, evaluation, differential diagnosis, and treatment of angioedema.

CLINICAL FEATURES

Angioedema generally develops over minutes to hours and resolves in 24 to 48 hours. The skin is either normal in color or erythematous, and pruritis is usually absent, unless the angioedema is associated with urticarial lesions (which are intensely pruritic) (picture 1 and picture 2). Pain and warmth are variably present. Angioedema resolves without leaving residual markings on the skin, unless there has been trauma induced by rubbing or scratching. Urticaria is presented elsewhere. (See "Etiology and diagnosis of urticaria".)

Although usually a benign condition, angioedema can be life-threatening if it involves the larynx. Laryngeal edema can progress to airway compromise and asphyxiation. Angioedema may also be a premonitory or accompanying symptom to an anaphylactic or anaphylactoid reaction. Anaphylaxis is presented in detail separately. (See "Anaphylaxis: Rapid recognition and treatment".)

Angioedema can be distinguished clinically from other forms of edema by the following characteristics:
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