Urticarial vasculitis treated with colchicine

Area of Science:

• Dermatology
• Rheumatology
• Immunology

Background:

• Cutaneous vasculitis can manifest as an urticaria-like rash, sometimes linked to viral illnesses or autoimmune conditions like lupus or Sjögren's syndrome.
• Urticarial vasculitis is frequently an immune complex-mediated disease, often occurring independently of other systemic diseases or infections.
• Conventional treatments including antihistamines, prednisone, and immunosuppressants have shown variable success in managing urticarial vasculitis.

Observation:

• Colchicine has previously demonstrated efficacy in non-urticarial cutaneous vasculitis.
• Two patients with refractory urticarial vasculitis, who had not responded to other treatments, were administered colchicine.
• Both patients experienced a dramatic positive response to colchicine therapy.

Findings:

• Colchicine treatment led to significant improvement in urticarial vasculitis symptoms in both studied patients.
• The therapeutic success was observed even in cases where standard treatments were ineffective.
• One patient maintained severe hypocomplementemia despite the clinical response to colchicine.

Implications:

• Colchicine represents a promising therapeutic option for patients suffering from urticarial vasculitis, particularly those with treatment-resistant disease.
• Further investigation into colchicine's mechanism in urticarial vasculitis is warranted.
• The persistent hypocomplementemia in one patient highlights the need for continued monitoring and potentially combination therapy.