swellling/hives

[Juliagoulia]

Hi I am a 21 year old female that has been experiencing hive since I was in 6th grade.They were dormat for many years until probably the end of high school. I recently got diagnosed with rheumatoid arthritis when I was 17 years old. I was taken Enbrel for it but found that I was getting an allergic reaction to it and experiencing hive everyday, all over-arms, legs, torso, face, lip, etc. Now I take Humira which is two injections twice a month. But before i started taking humira I started experiencing random swellings on my face.Such as my forehead will have a small quarter sized mass, the sides of upper lip, etc. But lately it has been especially with my chin-it will start swelling with a tiny mass and over a period of hours will gradual get bigger and firmer. Like Rock hard. It doesnt itch like a hive but it does hurt sometimes because my skin gets taunt and pulled from it getting so large. I had scratch tests done at  U of M doctors office, I was under the impression that the mass on my chin was a hive. The doctor said it wasnt-no one could tell me what it was. I even had a CAT scan to see if they could identify the mass. Long story short-no one could. They sent me to a facial plastic surgeon because they thought it might be a cyst. He drew fluid from it and couldnt get enough cells out to see what it was but the characteristics of it coming and going maybe twice a week didnt fit being a cyst. Then I got sent to a dermatologist-they didnt help either. I finally saw a third allergist to help with my frequent hives. I am not currently take a small dose of prednisone 5mg every other day with zyrtec and zantac. That seemed to help with my chin and other areas but in the past couple months it has been coming back and today, it has gotten the biggest it has in a long. I am frustrated and cant seem to get the help I need. Can anyone help me & give me some medical advice? Would this be consider angioedema?

[National Jewish Health]

What you have experienced must be very distressing and worrisome.  And, yes, the "masses" you describe are consistent with the diagnosis of angioedema, especially with your longtime history of hives.  However, nodules, and these "masses" may or may not be nodules, are also seen in approximately 25% of people with rheumatoid arthritis.  These nodules may wax and wane independently of arthritic activity.  Since aspiration has not provided an answer, it may be necessary to biopsy one of the nodules.

It appears that you have been evaluated by a number of capable, sub-specialist.  But, given the difficulty they have experienced in trying to establish a diagnosis of your "masses" you might want to consider seeking consultation with a university hospital affiliated rheumatologist, one engaged in both research and clinical care, a specialist such as those with the Division of Rheumatology at the University of Colorado Medical Center or its affiliate, National Jewish Health, both in Denver, Colorado.

Good luck.