Question: A 51-year-old man was referred to our tertiary medical center for a 3-year history of intermittent abdominal pain, diarrhea, and associated nontender, nonitchy cutaneous erythema and swelling of his upper and lower extremities (Figure A) and scrotum. Each episode lasted for 5 to 8 weeks before resolution. Medical history included gastroesophageal reflux disorder (on pantoprazole 40 mg/d) and essential hypertension (on losartan 50 mg/d for the past 3 years). Previous workup included unremarkable findings in esophagogastroduodenal scope and colonoscopy examinations within past 1 year.