Urticarial vasculitis
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References
Ang Urticarial vasculitis ay isang bihirang kondisyon na minarkahan ng pangmatagalan o paulit-ulit na mga yugto ng mga pantal. Bagama't ang mga sintomas nito sa balat ay maaaring maging katulad ng mga talamak na pantal, ang mga ito ay natatangi dahil ang mga pantal ay nananatili sa loob ng hindi bababa sa 24 na oras at maaaring magdulot ng mga dark spot pagkatapos mawala. Bagama't madalas na hindi alam ang dahilan, maaari itong minsan ay ma-trigger ng ilang partikular na gamot, impeksyon, autoimmune disease, mga sakit sa dugo, o mga kanser. Iniugnay pa nga ito ng ilang pag-aaral sa trangkaso ng COVID-19 at H1N1. Maaari rin itong makaapekto sa iba pang bahagi ng katawan tulad ng mga kalamnan, bato, baga, tiyan, at mata. Bagama't maaaring kumpirmahin ng isang partikular na uri ng pagsusuri sa tissue ang diagnosis, hindi ito palaging kinakailangan. Karaniwang nagsisimula ang paggamot sa mga antibiotic, dapsone, colchicine, o hydroxychloroquine para sa mas banayad na mga kaso. Para sa mas malalang kaso, maaaring kailanganin ang mga gamot na pumipigil sa immune system tulad ng methotrexate o corticosteroids. Kamakailan, ang mga biologic na therapy (rituximab, omalizumab, interleukin-1 inhibitors) ay nagpakita ng pangako para sa mga mahihirap na kaso.
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.
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.
Isang 35-taong-gulang na lalaki ang dumating na may 15-araw na kasaysayan ng matingkad na pula, masakit na mga pantal sa magkabilang hita at binti, kasama ang pananakit ng kasukasuan. Nagkaroon siya ng impeksyon sa ihi sa loob ng isang linggo bago lumitaw ang pantal. Ang kanyang balat ay nagpakita ng ilang malambot, hugis singsing, bahagyang namumulaklak, mapupulang plaka sa magkabilang gilid ng kanyang mga hita at binti. Binigyan siya ng oral prednisolone (40mg/araw) sa loob ng isang linggo kasama ng hindi nakakaantok na antihistamine (fexofenadine) . Sa loob ng isang linggo, ang lahat ng mga pantal ay ganap na nawala. Wala nang mga pantal sa susunod na 6 na buwan ng regular na check-up.
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.
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.
○ Paggamot ― OTC na Gamot
Kung mayroon kang lagnat (tumaas na temperatura ng katawan), inirerekomenda namin na humingi ka ng medikal na atensyon sa lalong madaling panahon.
Ang pinaghihinalaang gamot ay dapat na ihinto. (hal. antibiotics, non-steroidal anti-inflammatory drugs)
Oral antihistamines tulad ng cetirizine o loratadine para sa pangangati.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]
Ang mga OTC steroid ointment ay maaaring hindi epektibo para sa mababang potency. Kailangang mag-apply ng higit sa isang linggo para makita ang improvement.
#Hydrocortisone ointment