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The differential diagnosis of an upper forearm and hand oedema may be challenging.In order to reach the correct diagnosis and to prescribe proper treatment, careful examination and history taking is essential.All possible causes should be taken into proper consideration.Large local reaction (LLR) is characterized by hot, flushed and thick edema after a hymenoptera sting. As the risk of a systemic reaction, upon the first sting following a consistent index LLR, it is important to recognize an LLR in order to prescribe self-injectable epinephrine to prevent the occurrence of anaphylaxis.

A Very Big Hand Is a Very Big Problem: Soft-Tissue Infection, Venous Thrombosis, or Just an Insect Sting?