Sudden diffuse swelling and itching and redness in hand and disappear

Sudden diffuse swelling and itching and redness in hand and disappear after few hours

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The image retrieved is of angioedema of the foot (not the hand), so I'll skip embedding it. I now have enough information to give a thorough, well-sourced answer.

Urticaria (Hives) with Angioedema of the Hand

What you are describing - sudden diffuse swelling, itching, and redness in the hand that resolves within a few hours - is the classic presentation of urticaria (hives) with or without angioedema.

What Is Happening?

Urticaria is a vascular leak in the superficial dermis. The result is transient, pruritic (itchy), edematous wheals (welts) with surrounding redness (erythema). These lesions are caused by mediators - predominantly histamine - released from mast cells. They tend to occur on the extremities and the skin typically returns to normal within 24 hours, which is exactly what you describe.

Angioedema involves deeper edema in the subcutaneous tissue, producing larger, poorly defined swollen areas. When it accompanies urticaria, it is usually allergic (histaminergic) in nature.

ROSEN's Emergency Medicine, p. 2393
Tintinalli's Emergency Medicine, p. 1685

Classification

Type	Duration
Acute urticaria	Lasts < 6 weeks
Chronic urticaria	Lasts > 6 weeks
Inducible urticaria	Triggered by cold, heat, pressure, sun, water, or exercise

Common Triggers and Causes

Immunologic (IgE-mediated):

Foods (nuts, shellfish, eggs, milk, wheat)
Drugs - especially penicillin and beta-lactam antibiotics
Insect stings or bites
Infections (viral hepatitis, strep throat, fungal)

Non-immunologic:

NSAIDs and aspirin - most common non-immunologic cause; they alter prostaglandin metabolism, enhancing mast cell degranulation
Radiocontrast material
Opiates
ACE inhibitors (angiotensin-converting enzyme inhibitors) - can cause angioedema even months after starting the drug, via bradykinin accumulation

Physical / Inducible urticaria:

Cold contact (cold urticaria)
Heat contact, pressure, sunlight, water, exercise (cholinergic urticaria)
Andrews' Diseases of the Skin, p. 144

When to Be Concerned (Red Flags)

Urticaria of the hand resolving in a few hours is usually benign, but watch for signs of a more serious reaction:

Swelling spreading to the face, lips, tongue, throat, or larynx - risk of airway obstruction
Wheezing or difficulty breathing (bronchospasm)
Hypotension or fainting - suggests anaphylaxis
Associated abdominal cramps or vomiting

These features indicate anaphylaxis, which is a medical emergency requiring epinephrine (adrenaline) immediately.

Treatment

For mild urticaria/angioedema with no anaphylaxis:

First-line: 2nd-generation H1 antihistamines - cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra). These are preferred over older antihistamines due to fewer side effects. Up to 4x the standard dose may be used.
Adding an H2 antihistamine (e.g., famotidine) can help, since 15% of dermal histamine receptors are H2 type.
Short course of oral corticosteroids (e.g., prednisone 1 mg/kg/day up to 60 mg/day) as second-line if symptoms are significant or recurring.

For severe reactions:

Epinephrine IM (auto-injector / EpiPen) if anaphylaxis criteria are met.

For prevention:

Identify and avoid the trigger (food, drug, insect, physical stimulus).
A skin prick test or RAST (specific IgE blood test) can identify allergic triggers.
If you are on an ACE inhibitor, discuss with your doctor - this class of drug is a recognized cause of recurrent angioedema.
ROSEN's Emergency Medicine, p. 2393-2394
Tintinalli's Emergency Medicine, p. 1686

Key Takeaway

Sudden swelling + itching + redness in the hand that resolves in a few hours = acute urticaria ± angioedema, most likely a hypersensitivity/allergic reaction. Think about what you were exposed to in the hours before it happened - a new food, drug, soap, or animal contact is often the culprit. If episodes recur, see a doctor for allergy testing. If you ever notice throat swelling or difficulty breathing, seek emergency care immediately.

Disclaimer: This is educational information only and not a substitute for professional medical evaluation. Please see a doctor if symptoms recur or worsen.

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