Više informacija ― Hrvatski

Urticarial vasculitis je rijetko stanje obilježeno dugotrajnim ili ponavljajućim epizodama koprivnjače. Iako njezini kožni simptomi mogu nalikovati kroničnoj koprivnjači, jedinstveni su po tome što se koprivnjača zadržava najmanje 24 sata i može ostaviti tamne mrlje nakon što izblijedi. Uzrok je često nepoznat, ali ga ponekad mogu potaknuti određeni lijekovi, infekcije, autoimune bolesti, poremećaji krvi ili rak. Neke studije su ga čak povezale s COVID‑19 i H1N1 gripom. Bolest može zahvatiti i druge organe – mišiće, bubrege, pluća, želudac i oči. Iako biopsija tkiva može potvrditi dijagnozu, nije uvijek nužna. Liječenje obično započinje antibioticima, dapsonom, kolhicinom ili hidroksiklorokinom kod blažih slučajeva. U težim oblicima mogu biti potrebni lijekovi koji suzbijaju imunološki sustav, poput metotreksata ili kortikosteroida. Nedavno su biološke terapije (rituximab, omalizumab, interleukin‑1 inhibitors) pokazale obećavajuće rezultate kod teških slučajeva.
Urticarial vasculitis is a rare clinicopathologic entity that is characterized by chronic or recurrent episodes of urticarial lesions. Skin findings of this disease can be difficult to distinguish visually from those of chronic idiopathic urticaria but are unique in that individual lesions persist for ≥24 hours and can leave behind dusky hyperpigmentation. This disease is most often idiopathic but has been linked to certain drugs, infections, autoimmune connective disease, myelodysplastic disorders, and malignancies. More recently, some authors have reported associations between urticarial vasculitis and COVID-19, as well as influenza A/H1N1 infection. Urticarial vasculitis can extend systemically as well, most often affecting the musculoskeletal, renal, pulmonary, gastrointestinal, and ocular systems. Features of leukocytoclastic vasculitis seen on histopathologic examination are diagnostic of this disease, but not always seen. In practice, antibiotics, dapsone, colchicine, and hydroxychloroquine are popular first-line therapies, especially for mild cutaneous disease. In more severe cases, immunosuppressives, including methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine, as well as corticosteroids, may be necessary for control. More recently, select biologic therapies, including rituximab, omalizumab, and interleukin-1 inhibitors have shown promise for the treatment of recalcitrant or refractory cases.

Došao je 35‑godišnji muškarac s 15‑dnevnom poviješću svijetlocrvenih, bolnih osipa na bedrima i nogama, uz bolove u zglobovima. Tjedan dana prije pojave osipa imao je urinarnu infekciju. Na koži su se pojavile nekoliko nježnih, prstenastih, djelomično blijedih, crvenih pločica na obje strane bedara i nogu. Propisan mu je oralni prednisolon 40 mg dnevno tijekom tjedan dana, uz antihistaminik koji ne izaziva pospanost – fexofenadin. Unutar tjedan dana svi su osipi potpuno nestali. Tijekom sljedećih šest mjeseci redovitih kontrola nije bilo ponovnog pojavljivanja osipa.
A 35-year-old man came in with a 15-day history of bright red, painful rashes on both thighs and legs, along with joint pain. He had a urinary tract infection for a week before the rash appeared. His skin showed several tender, ring-shaped, partially blanchable, red plaques on both sides of his thighs and legs. He was given oral prednisolone (40mg/day) for a week along with a non-drowsy antihistamine (fexofenadine). Within a week, all the rashes disappeared completely. There were no more rashes during the next 6 months of regular check-ups.