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Urticarial vasculitis 是一種罕見疾病，其特徵是蕁麻疹長期持續或反覆發作。雖然其皮膚症狀可能類似於慢性蕁麻疹，但它們很獨特，因為蕁麻疹會持續至少 24 小時，且在退色後可能留下黑斑。儘管大多數情況原因不明，仍可能與某些藥物、感染、自體免疫疾病、血液疾病或癌症有關。部分研究甚至將其與 COVID-19 與 H1N1 流感相關聯。此疾病亦可累及身體其他部位，如肌肉、腎臟、肺、胃和眼睛。雖然組織活檢（皮膚活檢）可確診，但並非所有患者都必須進行。對於較輕微的病例，治療通常先使用抗組織胺、氨苯砜、秋水仙鹼或羥氯奎寧。對於較嚴重的情形，可能需要使用免疫抑制劑，如甲氨蝶呤或皮質類固醇。近年來，生物製劑（rituximab、omalizumab、interleukin-1 inhibitors）在難治性病例中展現出希望。
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.

一名 35 歲男性入院，已有 15 天的大腿與小腿出現鮮紅、疼痛性皮疹，伴關節疼痛的病史。皮疹出現前，他曾因尿路感染接受治療一週。檢查時，雙側大腿與小腿皮膚呈現數處柔軟、環形、部分呈白色的紅斑。醫師給予口服潑尼松龍（40 毫克/天）及非嗜睡抗組織胺（非索非那定）治療，為期一週。治療後一週內，所有皮疹完全消失。隨後於 6 個月的定期追蹤中，未再出現皮疹。
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.