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Persistent urticaria--urticarial reaction caused by late phase reaction?
A Kitao1, S Nobuhara, S Kore-Eda
1Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. akitao@rg.med.kyoto-u.ac.jp
European Journal of Dermatology : EJD
|August 30, 2001
Summary
This study describes a rare form of urticaria with lesions lasting over 24 hours. These cases, unresponsive to standard treatments, suggest a distinct clinical entity possibly linked to late-phase allergic reactions.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Ordinary urticaria lesions typically resolve within 24 hours.
- Distinguishing chronic urticarial variants is crucial for effective management.
Observation:
- Three patients presented with urticarial reactions persisting beyond 24 hours.
- Skin biopsies showed interstitial dermal edema and eosinophilic perivascular infiltration.
- These reactions were refractory to conventional medications but responsive to glucocorticoids.
Findings:
- Histopathology excluded common urticarial mimics like urticarial vasculitis.
- Normal eosinophil counts and serum complement levels ruled out systemic eosinophilia and complement-mediated processes.
- The clinical course and biopsy findings suggest a unique urticarial entity.
Implications:
- These cases represent a distinct clinical entity beyond ordinary urticaria.
- The findings suggest a potential role for late-phase hypersensitivity reactions.
- Further research is warranted to elucidate the specific mechanisms and optimal treatment strategies.