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Urticarial vasculitis.

Joe Venzor1, Wai L Lee, David P Huston

  • 1Immunology Allergy and Rheumatology Section, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.

Clinical Reviews in Allergy & Immunology
|September 12, 2002
PubMed
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Urticarial vasculitis presents as recurrent hives with leukocytoclastic vasculitis features, often requiring a skin biopsy for diagnosis. Differentiating it from allergic urticaria is key, as treatment varies based on severity and systemic involvement.

Area of Science:

  • Dermatology
  • Pathology
  • Immunology

Background:

  • Urticarial vasculitis is a condition characterized by recurrent urticaria with histopathologic leukocytoclastic vasculitis.
  • Clinical presentation can include painful, persistent lesions (>24 hours), palpable purpura, and residual hyperpigmentation.
  • Diagnosis requires a lesional skin biopsy due to overlap with allergic urticaria.

Purpose of the Study:

  • To provide a comprehensive overview of urticarial vasculitis, including its clinical features, diagnostic criteria, and management strategies.
  • To highlight the importance of distinguishing urticarial vasculitis from allergic urticaria.
  • To discuss the association with autoimmune disorders and the prognostic implications of complement levels.

Main Methods:

  • Review of clinico-pathologic features of urticarial vasculitis.

Related Experiment Videos

  • Analysis of diagnostic requirements, including skin biopsy.
  • Examination of associations with other conditions and laboratory findings (e.g., ESR, serum complement).

    • Main Results:

    • Urticarial vasculitis can be idiopathic or associated with autoimmune disorders, infections, drug reactions, or paraneoplastic syndromes.
    • Elevated erythrocyte sedimentation rate and reduced serum complement are common in idiopathic cases.
    • Hypocomplementemic urticarial vasculitis is linked to more severe systemic involvement and poorer prognosis compared to normocomplementemic cases.

    Conclusions:

    • Accurate diagnosis of urticarial vasculitis relies on clinical and histopathologic correlation, necessitating skin biopsy.
    • Treatment approaches vary, ranging from antihistamines and dapsone for mild cases to corticosteroids and immunosuppressants for severe or refractory disease.
    • Understanding complement levels is crucial for predicting disease severity and guiding therapeutic decisions.