Urticarial Vasculitis: A Retrospective Study of 15 Cases

Moreno-Suárez, F.; Pulpillo-Ruiz, Águeda; Dorado, Teresa Zulueta; Sánchez, Julián Conejo-Mir

doi:10.1016/j.adengl.2012.12.005

Cited by 19 publications

(21 citation statements)

References 15 publications

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“…ÜV kutanöz lökositoklastik vaskülitin ürtikeryal lezyonlarla karakterize bir alt tipi olarak tanımlanmakla birlikte, bazı yazarlar tarafından ürtiker başlığı altında da sınıflandırılmaktadır 1,3,4 . Bu tablo genellikle olguların %90'ından fazlasında ürtikeryal lezyonların 24 saatten uzun süre devam etmesi ve sıklıkla 3-4 gün sürebilmesi, kaşıntıdan ziyade yanma ve ağrının eşlik etmesi, viyole renkli olması, merkezinde purpurik odaklar bulunabilmesi, postinflamatuvar hiperpigmentasyonla gerilemesi ve sistemik semptomların eşlik edebilmesi açısından klasik ürtikerden ayrılabilir 3,5,6 . Bununla birlikte ürtikeryal lezyonları olan ve kuşkulanılan olgularda ÜV tanısını dışlamak için biyopsi alınmasının gerekliliğinden bahsedilmiştir 1,2 .…”

Section: Discussionunclassified

Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

Akarsu¹,

İlknur²,

Özbağçıvan³

et al. 2015

TURKDERM

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Background and Design: Chronic spontaneous urticaria (CSU), the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV) is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patients with CSU and UV. Materials and Methods: In this study, the files of CSU (n=146) and UV (n=43) patients who had been hospitalized between January 2010-December 2013 were retrospectively reviewed in terms of demographic data, disease-specific history, accompanying diseases, medications and laboratory findings. Results: When comparing between the two groups for statistical differences, it was found that the frequencies of personal atopy and angioedema were significantly higher in patients with CSU; however, the patients with UV had significantly higher rates for female gender and the presence of systemic symptoms compared to those with CSU. It was determined that the mean values for erythrocyte sedimentation rate and C-reactive protein, as well as the rates of antinuclear antibody positivity and hypocomplementemia were significantly higher in the UV group, compared with those in the CSU group. Accompanying factors were determined as infections, medications, autoimmune diseases and malignities in order of frequency in both CSU and UV groups, but only the frequency of autoimmune diseases was significantly higher in patients with UV group.

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Section: Discussionunclassified

Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

Akarsu¹,

İlknur²,

Özbağçıvan³

et al. 2015

TURKDERM

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“…The CSU definition was based on international consensus [9] . Diseases related to urticaria/angioedema were excluded, particularly urticaria vasculitis and hypocomplementemic urticaria vasculitis syndrome [21][22][23] , since these abnormalities are associated with localized, nonblanching, painful lesions [23] which persist for >24 h and leave brownish residues when healed [22] .…”

Section: Discussionmentioning

confidence: 99%

Chronic Spontaneous Urticaria: A Survey of 852 Cases of Childhood-Onset Systemic Lupus Erythematosus

Ferriani

Silva

Pereira

et al. 2015

Int Arch Allergy Immunol

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Background: Data regarding the prevalence of chronic spontaneous urticaria (CSU) in childhood-onset systemic lupus erythematosus (cSLE) patients and possible associated factors are limited to a few case reports. The objectives of this study were to assess CSU in a large cSLE population, in order to evaluate the demographic data, clinical manifestations, disease activity/damage, laboratory abnormalities and treatment. Methods: A retrospective multicenter cohort study (Brazilian cSLE group) was performed in 10 Pediatric Rheumatology services and included 852 cSLE patients. CSU was diagnosed according to the guidelines of the European Academy of Allergy and Clinical Immunology, the Global Allergy and Asthma European Network, the European Dermatology Forum and the World Allergy Organization. Patients with CSU (evaluated at urticaria diagnosis) and patients without CSU (evaluated at the last visit) were assessed for lupus clinical/laboratory features and treatment. Results: CSU was observed in 10/852 cSLE patients (1.17%). The median of cSLE duration at urticaria diagnosis was 0 (-3 to 5) years. Comparison of cSLE patients with and without CSU revealed a greater frequency of constitutional symptoms (40 vs. 8%, p = 0.006), reticuloendothelial system involvement (30 vs. 3%, p = 0.003), mucocutaneous (90 vs. 28%, p < 0.0001) and musculoskeletal manifestations (50 vs. 6%, p < 0.0001) and methylprednisolone pulse therapy use (60 vs. 9%, p < 0.0001) in the former group. The frequency of immunosuppressive treatment was lower in patients with CSU (p = 0.018). The median SLE Disease Activity Index 2000 (12 vs. 2, p < 0.0001) and erythrocyte sedimentation rate (40 vs. 19 mm/1st hour, p = 0.024), was higher in patients with CSU. Conclusions: To our knowledge, this is the first study with evidence that CSU may be linked to cSLE. We also demonstrated that this particular skin manifestation occurs predominantly at disease onset and is associated with lupus moderate/high disease activity without major organ involvement.

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“…As UV is considered a systemic vasculitis which needs evaluation for extracutaneous manifestations and associated disorders, diagnostic and clinical approach is totally different from that of urticaria . Besides, it seems that UV is more common than previously considered.…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic infiltration: an under‐reported histological finding in urticarial vasculitis

et al. 2019

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Background Urticarial vasculitis (UV) is a clinicopathologic entity in which skin lesions resemble urticaria clinically but last more than 24 hours and resolve with residual purpura. In this study, we evaluated distinguishing histological features of UV from common urticaria to differentiate between these two entities. Methods During 1 year, 55 urticaria and 245 UV samples were assessed. The selection criteria for UV included: (1) samples that the histological diagnosis was confirmed by two independent dermatopathologists, (2) the histological diagnosis of UV was inconsistent with the first clinical impression and lesion characteristics. Results Of our 245 UV patients, 96% had endothelial swelling, 18% had red blood cell (RBC) extravasation, neutrophilic infiltration was seen in 46.7%, and perivascular, interstitial, and perineural eosinophilic infiltration in 198 (81.8%), 181 (74.2%), and 118 (48.1%), respectively. Among different histological findings, endothelial cell swelling as well as neutrophil around vessels and eosinophilic infiltrations were statistically different between two groups (P‐value ˂ 0.001). Both urticaria and UV samples showed a predominantly lymphocytic infiltration more than 10 cells per high power field (HPF) (98.2% of urticaria, 98.8% of UV), and only two patients (0.8%) with UV had predominant neutrophilic infiltration (more than 10 cells/HPF). Conclusion We have found that both urticaria and UV showed a predominantly lymphocytic infiltration along with RBC extravasation, endothelial cell swelling, and fibrin deposition in UV. Moreover, significant perineural, perivascular, and interstitial infiltration of eosinophil in UV lesions compared to urticaria was another point that indicates special contribution of these cells in UV pathogenesis.

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Urticarial Vasculitis: A Retrospective Study of 15 Cases

Cited by 19 publications

References 15 publications

Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

Chronic Spontaneous Urticaria: A Survey of 852 Cases of Childhood-Onset Systemic Lupus Erythematosus

Eosinophilic infiltration: an under‐reported histological finding in urticarial vasculitis

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