June 2nd 2008
Swelling of the wrists and ankles of 3 months' duration prompted a 33-year-old man to seek medical attention. The swelling was highly migratory, with periods of regression that lasted several days at a time. The patient also had a 3-year history of "breaking out" after contact with water. He had no personal or family history of asthma, allergies, or other atopic disorders. He was not taking any medications.