Informasi lebih lanjut ― Bahasa indonesia

Urticarial vasculitis adalah kondisi langka yang ditandai dengan serangan gatal‑gatal yang berlangsung lama atau berulang. Meskipun gejala kulitnya menyerupai urtikaria kronis, lesinya unik karena bertahan setidaknya 24 jam dan dapat meninggalkan bintik hitam setelah mereda. Penyebabnya sering tidak diketahui, namun dapat dipicu oleh obat‑obatan tertentu, infeksi, penyakit autoimun, kelainan darah, atau kanker. Beberapa penelitian bahkan mengaitkannya dengan COVID‑19 dan flu H1N1. Penyakit ini juga dapat melibatkan organ lain seperti otot, ginjal, paru‑paru, perut, dan mata. Pemeriksaan jaringan tertentu dapat memastikan diagnosis, tetapi tidak selalu diperlukan. Pengobatan biasanya dimulai dengan antibiotic, dapsone, colchicine, atau hydroxychloroquine untuk kasus ringan. Pada kasus yang lebih parah, obat yang menekan sistem kekebalan seperti methotrexate atau corticosteroid mungkin diperlukan. Baru‑baru ini, terapi biologis (rituximab, omalizumab, interleukin‑1 inhibitors) menunjukkan harapan untuk kasus sulit.
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.

Seorang pria berusia 35 tahun datang dengan keluhan ruam merah cerah dan nyeri pada kedua paha serta kaki selama 15 hari, disertai nyeri sendi. Ia pernah mengalami infeksi saluran kemih satu minggu sebelum ruam muncul. Pemeriksaan kulit menunjukkan beberapa plak merah lembut berbentuk cincin, dengan bagian tengah yang agak pucat, terletak di kedua sisi paha dan kaki. Ia diberikan prednisolon oral (40 mg/hari) selama satu minggu bersama antihistamin non‑mengantuk (fexofenadine). Dalam seminggu, seluruh ruam menghilang sepenuhnya. Tidak ada kekambuhan ruam selama enam bulan setelah pemeriksaan rutin.
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.