Urticarial vasculitis - 荨麻疹性血管炎
References
Urticarial vasculitis 是一种罕见疾病，其特征是荨麻疹长期持续或反复发作。虽然其皮肤症状可能类似于慢性荨麻疹，但它们很独特，因为荨麻疹会持续至少 24 小时，并且在褪色后可能会导致黑斑。尽管通常原因不明，但有时也可能由某些药物、感染、自身免疫性疾病、血液疾病或癌症引发。一些研究甚至将其与 COVID-19 和 H1N1 流感联系起来。它还会影响身体的其他部位，如肌肉、肾脏、肺、胃和眼睛。虽然某种类型的组织检查可以确诊，但这并不总是必要的。对于较轻的病例，治疗通常从抗生素、氨苯砜、秋水仙碱或羟氯喹开始。对于更严重的病例，可能需要抑制免疫系统的药物，如甲氨蝶呤或皮质类固醇。最近，生物疗法 (rituximab, omalizumab, interleukin-1 inhibitors) 对疑难病例显示出了希望。
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.
一名 35 岁男性入院，已有 15 天的大腿和小腿出现鲜红色、疼痛性皮疹以及关节疼痛的病史。在出现皮疹之前，他患有尿路感染一周。他的大腿和小腿两侧的皮肤出现了几处柔软的、环形的、部分变白的红色斑块。他接受了为期一周的口服泼尼松龙（40 毫克/天）以及非嗜睡抗组胺药（非索非那定）治疗。一周之内，所有皮疹完全消失。在接下来的6个月的定期检查中，没有再出现皮疹。
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.
○ 治疗 - 非处方药
如果您发烧（体温升高），我们建议您尽快就医。
应停用可疑药物。 （例如抗生素、非甾体抗炎药）
口服抗组胺药，例如西替利嗪或氯雷他定止痒。
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]
非处方类固醇软膏可能因效力低而无效。需要坚持一周以上才能看到改善。
#Hydrocortisone ointment