Inpo leuwih ― Urang sundan

Urticarial vasculitis mangrupikeun kaayaan anu jarang, ditandaan ku épisode gatal-gatal anu berkepanjangan atanapi kambuh. Sanaos gejala kulitna tiasa mirip gatal-gatal kronis, éta unik sabab bintik gatal tetep aya sahenteuna 24 jam sareng tiasa nyababkeun bintik poék sanggeus luntur. Sanajan sering sababna teu dipikanyaho, kadang tiasa dipicu ku pangobatan, inféksi, panyakit otoimun, gangguan getih, atawa kanker. Sababaraha panalungtikan malah geus ngaitkeunana jeung flu COVID-19 sareng H1N1. Éta ogé tiasa mangaruhan organ séjén sapertos otot, ginjal, hati, lambung, jeung panon. Sanajan hiji tipe pamariksaan jaringan bisa mastikeun diagnosis, éta teu salawasna diperlukeun. Pangobatan biasana dimimitian ku antibiotik, dapsone, colchicine, atawa hydroxychloroquine pikeun kasus anu hampang. Pikeun kasus anu leuwih parah, ubar nu ngirangan sistem imun saperti methotrexate atawa kortikosteroid bisa diperlukeun. Anyar-anyar ieu, terapi biologis (rituximab, omalizumab, interleukin-1 inhibitors) geus nunjukkeun hasil anu ngajangjikeun pikeun kasus anu parah.
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.

Hiji lalaki umur 35 taun datang kalayan sajarah 15 poé beureum caang, ruam anu nyeri dina duanana pingping jeung suku, babarengan jeung nyeri sendi. Anjeunna ngalaman inféksi saluran kemih salila saminggu saméméh baruntus mucunghul. Kulitna némbongkeun sababaraha lesi lemes, bentukna cingcin, sawarna blanchable, sarta plak beureum dina dua sisi pingping jeung suku. Anjeunna dibéré prednisolone lisan (40 mg/dinten) salila saminggu babarengan jeung antihistamine non‑drowsy (fexofenadine). Dina saminggu, sadaya ruam geus leungit lengkep. Teu aya ruam deui salami 6 sasih pamariksaan 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.