Urticarial vasculitis - 荨麻疹性血管炎
relevance score : -100.0%
ReferencesUrticarial 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，但它们具有独特之处：荨麻疹持续时间至少 24 小时，退色后可能留下黑斑。尽管多数病例原因不明，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。部分研究甚至将其与 COVID-19 和 H1N1 流感关联。该疾病还可累及其他部位，如肌肉、肾脏、肺、胃和眼睛。组织检查可确诊，但并非所有患者都必须进行。轻度病例通常先使用抗生素、氨苯砜、秋水仙碱或羟氯喹；重症患者可能需要免疫抑制剂，如甲氨蝶呤或皮质类固醇。最近，生物疗法 (rituximab, omalizumab, interleukin-1 inhibitors) 在疑难病例中显示出希望。
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、疼痛性皮疹并伴有关节疼痛的病史。皮疹出现前，他曾有一周的尿路感染。其大腿和小腿两侧皮肤出现数处柔软、环形、部分呈白色的红斑。患者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。治疗一周后，所有皮疹完全消失。随后在6个月的随访中未再出现皮疹。
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
如果您发热（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）。
可口服抗组胺药，如西替利嗪或氯雷他定，以缓解瘙痒。
#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