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Neutrophilic urticaria.

M S Peters, R K Winkelmann

    The British Journal of Dermatology
    |July 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Histological findings of neutrophil inflammation in dermal venules of urticaria patients may indicate physical urticaria, not early urticarial vasculitis. This suggests a link between specific skin biopsy results and physical urticaria diagnoses.

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    Area of Science:

    • Dermatology
    • Pathology
    • Immunology

    Background:

    • Urticaria is a common skin condition characterized by transient, itchy wheals.
    • Urticarial vasculitis is a distinct entity with prolonged lesions and potential systemic involvement.
    • Distinguishing urticarial vasculitis from other forms of urticaria is crucial for appropriate management.

    Purpose of the Study:

    • To investigate the clinical and histological features of urticarial lesions.
    • To determine if specific histological findings in urticaria biopsies correlate with particular subtypes.
    • To differentiate potential early urticarial vasculitis from other urticarial conditions.

    Main Methods:

    • Analysis of 241 consecutive skin biopsies from patients diagnosed with urticaria.

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  • Histopathological examination of biopsy specimens, focusing on dermal venule inflammation.
  • Review of clinical histories, laboratory data, and immunofluorescence findings for relevant cases.
  • Main Results:

    • Ten out of 241 biopsies (approximately 4.1%) showed inflammation of dermal venules with polymorphonuclear leukocytes.
    • These 10 cases lacked evidence of necrotizing vasculitis.
    • Clinical data revealed associations with dermographism, normocomplementemia, and negative direct immunofluorescence in most of these cases.

    Conclusions:

    • The histological finding of neutrophils in vessel walls within urticarial lesions may suggest physical urticaria.
    • This histological pattern, in the absence of necrotizing vasculitis, is less indicative of early urticarial vasculitis.
    • Clinical correlation, including tests for physical urticaria, is essential when encountering this specific histological presentation.