Više informacija ― Hrvatski

Urticarial vasculitis je rijetko stanje obilježeno dugotrajnim ili ponavljajućim epizodama koprivnjače. Iako njezini kožni simptomi mogu nalikovati kroničnoj koprivnjači, jedinstveni su jer se koprivnjača zadržava najmanje 24 sata i može uzrokovati tamne mrlje nakon što izblijedi. Iako je često nepoznatog uzroka, ponekad ga mogu potaknuti određeni lijekovi, infekcije, autoimune bolesti, poremećaji krvi ili rak. Neke su ga studije čak povezale s COVID-19 i H1N1 gripom. Također može utjecati na druge dijelove tijela poput mišića, bubrega, pluća, želuca i očiju. Iako određena vrsta pregleda tkiva može potvrditi dijagnozu, to nije uvijek potrebno. Liječenje obično započinje antibioticima, dapsonom, kolhicinom ili hidroksiklorokinom za blaže slučajeve. U težim slučajevima mogu biti potrebni lijekovi koji suzbijaju imunološki sustav poput metotreksata ili kortikosteroida. Nedavno su biološke terapije (rituximab, omalizumab, interleukin-1 inhibitors) obećavale teške slučajeve.
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, zajedno s bolovima u zglobovima. Imao je urinarnu infekciju tjedan dana prije pojave osipa. Koža mu je pokazala nekoliko nježnih, prstenastih, djelomično blijedih, crvenih pločica s obje strane bedara i nogu. Dobio je oralni prednizolon (40 mg/dan) tjedan dana zajedno s antihistaminikom koji ne izaziva pospanost (feksofenadin) . U roku od tjedan dana svi su osipi potpuno nestali. Sljedećih 6 mjeseci redovitih kontrola više nije bilo 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.