Več informacij ― Slovenščina

Urticarial vasculitis je redko stanje, ki ga zaznamujejo dolgotrajne ali ponavljajoče se epizode koprivnice. Čeprav lahko njegovi kožni simptomi spominjajo na kronično koprivnico, so edinstveni, ker koprivnica traja vsaj 24 ur in lahko pusti temne madeže, ko zbledi. Vzrok je pogosto neznan, včasih pa ga sprožijo določena zdravila, okužbe, avtoimunske bolezni, krvne motnje ali rak. Nekatere študije so ga celo povezale s COVID‑19 in gripo H1N1. Bolezen lahko prizadene tudi druge organe, kot so mišice, ledvice, pljuča, želodec in oči. Za potrditev diagnoze je včasih potrebna preiskava tkiva, vendar ni vedno nujna. Zdravljenje se običajno začne z antibiotiki, dapsonom, kolhicinom ali hidroksiklorokinom pri blažjih oblikah. V hujših primerih so potrebna imunosupresivna zdravila, kot sta metotreksat ali kortikosteroidi. V zadnjem času so biološke terapije (rituximab, omalizumab, interleukin‑1 inhibitors) obetavne za težke primere.
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.

35-letni moški je prišel s 15‑dnevno zgodovino svetlo rdečih, bolečih izpuščajev na obeh stegnih in nogah, skupaj z bolečinami v sklepih. Teden dni pred pojavom izpuščaja je imel vnetje sečil. Na koži je na obeh straneh stegen in nog opazil nekaj nežnih, obročastih rdečih oblog, ki so se delno pobelele. Teden dni je prejemal peroralni prednisone (40 mg/dan) skupaj z antihistaminikom fexofenadine, ki ne povzroča zaspanosti. V enem tednu so vsi izpuščaji popolnoma izginili. V naslednjih šestih mesecih rednih pregledov ni bilo več izpuščajev.
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.