Hey Mike--
There are a lot of reasons to have angioedema, most of which ARE NOT malignancy-related. There are several types of adult onset angioedema hereditary angioedema (HAE) and acquired angioedema (AAE), which are fairly easy to differentiate based on history and a few simple labs.
Couple of questions: do your lips itch or hurt before they swell? Also, have you ever had eyelid, tongue, or airway involvement?
The hand swelling and the itchy rash on your body all fit with urticaria, or plain old hives. You almost never see HAE with urticaria elsewhere, so that's reassuring. The AAEs are divided into types I and II, and an idiopathic (we don't know what the hell causes it) variant. Type I IS associated with lymphoproliferative diseases, lymphoma being one of them. However, it is VERY rare. AAEII is even more rare, and is due to antibodies against one of the many constituents of your serum complement. The most common one is the idiopathic variant,and it's manageable with stanazol and other synthetic androgens.
Saving the best for last--the response to antihistamines makes me suspect that this is all just plain urticaria (50% of people will have angioedema with their plain vanilla urticaria). This can be caused by simply a ton of things--viral infections, tooth abcesses, sinus infections, drugs (antibiotics often kick it off, aspirin is also often implicated), as well as various foods including shellfish, strawberries, onions, garlic, spices, chocolate, tomatoes, cheese, and peanuts (that list is not all-inclusive, btw), and, big bummer--alcohol.
Now, one last question: do you have hives and angioedema almost every single day, or is it episodic? If the former, you're in the chronic urticaria category, which 80% of the time, we never figure out the provocative factor. If it happens often but not daily, or is episodic, it's most likely just recurring acute urticaria, and if you start to keep a log of what you eat and what you're doing every day, you can probably pinpoint the cause. Get ready to live on zyrtec for a while.
Let me know if you have any other questions. Hope this helps.
Tina
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