Iktar informazzjoni ― Malti

Urticarial vasculitis hija kundizzjoni rara mmarkata minn episodji ta' ħorriqija fit-tul jew rikorrenti. Filwaqt li s-sintomi tal-ġilda jistgħu jixbħu ħorriqija kroniku, huma uniċi minħabba li l-ħorriqija tkompli għal mill-inqas 24 siegħa u tista’ tħalli tikek skuri wara li tisparixxi. Għalkemm ħafna drabi ta'kawża mhux magħrufa, xi drabi jistgħu jiġu attivati minn ċerti mediċini, infezzjonijiet, mard awtoimmuni, disturbi tad-demm, jew kanċer. Xi studji saħansitra rabtuha mal‑COVID‑19 u l‑influwenza H1N1. Jista' wkoll jaffettwa partijiet oħra tal-ġisem bħall‑muskoli, il‑kliewi, il‑pulmuni, l‑istonku u l‑għajnejn. Filwaqt li ċertu tip ta'eżami tat‑tessut jista' jikkonferma d‑dijanjosi, mhux dejjem ikun meħtieġ. It‑trattament tipikament jibda b'antibijotiċi, dapsone, colchicine, jew hydroxychloroquine għal każijiet aktar ħfief. Għal każijiet aktar severi, jistgħu jkunu meħtieġa mediċini li jrażżnu s‑sistema immuni bħal methotrexate jew kortikosterojdi. Riċentement, terapiji bijoloġiċi (rituximab, omalizumab, interleukin‑1 inhibitors) wrew wegħda għal każijiet iebsa.
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.

Raġel ta’ 35 sena daħal b’storja ta’ 15 jum ta’ raxx aħmar u għajjat, u bl-uġigħ kemm fuq il‑koxox kif ukoll fuq ir‑riġlejn, flimkien ma’ uġigħ fil‑ġogi. Kellu infezzjoni fl‑apparat urinarju għal ġimgħa qabel ma deher ir‑raxx. Ġilda tiegħu wriet diversi plakek ħomor teneri, f’forma ta’ ċirku, parzjalment bajdabbli, fuq iż-żewġ naħat ta’ koxox u saqajh. Inħata prednisolone orali (40 mg/ jum) għal ġimgħa flimkien ma’ anti‑istaminiku li ma jagħmilx ħedla (fexofenadine). Fi żmien ġimgħa, ir‑raxxijiet kollha sparixxew kompletament. Ma kienx hemm iktar raxx matul is‑6 xhur li ġejjin ta’ check‑ups regolari.
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.