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Related Experiment Videos

Surface microscopy for discriminating between common urticaria and urticarial vasculitis.

F Vázquez-López1, C Maldonado-Seral, T Soler-Sánchez

  • 1Department of Dermatology, Centrak University Hospital, University of Oviedo, Oviedo, Spain. fvlopez@telecable.es

Rheumatology (Oxford, England)
|May 6, 2003
PubMed
Summary

Skin surface microscopy can differentiate common urticaria from urticarial vasculitis. The presence of purpuric globules under dermoscopy indicates underlying leucocytoclastic vasculitis, aiding clinical diagnosis.

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Area of Science:

  • Dermatology
  • Pathology
  • Medical Imaging

Background:

  • Urticarial vasculitis shares clinical features with common urticaria, necessitating biopsy for accurate diagnosis.
  • Distinguishing between these conditions in daily practice can be challenging.

Purpose of the Study:

  • To evaluate the utility of skin surface microscopy in differentiating common urticaria from urticarial vasculitis.
  • To assess if dermoscopic findings correlate with histological evidence of vasculitis.

Main Methods:

  • A pilot study involving 20 patients with clinically diagnosed urticaria.
  • Skin surface microscopy (10x dermoscope) and biopsy were performed on urticarial lesions.
  • Statistical analysis included Fisher's exact test and Cohen kappa statistics for reproducibility.

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Main Results:

  • Two distinct dermoscopic patterns were identified: a red-lined vascular pattern (17/20) and a purpuric globular pattern (3/20).
  • Purpuric globules were significantly associated with histological evidence of leucocytoclastic vasculitis (P < 0.0008).
  • Excellent intra-observer reproducibility was achieved for scoring dermoscopic features.

Conclusions:

  • Skin surface microscopy, particularly the detection of purpuric globules, can aid in the clinical differentiation of urticarial vasculitis.
  • This non-invasive technique shows promise for routine dermatological practice.
  • Purpuric globules observed via dermoscopy are a strong indicator of underlying leucocytoclastic vasculitis.