Informationes plurimae ― Latine

Urticarial vasculitis rara condicio est, diuturna vel frequentissima, a pluribus episodis notata. Cum eius cutis indicia possunt similes urticariis longis, unica sunt, quia urticariae inhaerent circa quattuor saltem horas et post evanescere maculas causare possunt. Etiam saepe causa ignota est; interdum autem a quibusdam medicamentis, infectionibus, morbis autoimmunibus, morbis sanguinis vel carcinomatis provocatur. Quaedam studia etiam cum COVID‑19 et H1N1 flu (influenza) coniuncta sunt. Etiam alias partes corporis afficit, sicut muscula, renes, pulmones, stomachum et oculos. Dum quaedam species texturae diagnosis confirmare possunt, non semper necessarium est. Curatio typice incipit cum antibioticis, dapsone, colchicino vel hydroxychloroquino in casibus levioribus. In casibus gravioribus, medicamenta quae systema immune suppriment, sicut methotrexatum vel corticosteroides, opus erunt. Nuper therapiae biologicae (rituximab, omalizumab, interleukin‑1 inhibitors) promissionem pro casibus gravibus ostenderunt.
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.

Vir XXXV annorum venit cum historia XV dierum minima, doloribus epinyctidis in utris femoribus et cruribus, cum dolore articulorum. Habuit infectionem tractus urinarii per hebdomadam antequam febris apparuit. Eius pellis varia tenella, annosa, partim blanchida, maculae rubrae in utris lateribus femorum et crurum ostendit. Data est prednisolone oralis (40 mg/die) una hebdomada cum antihistaminico non‑dorsali (fexofenadine). Intra septimanam, omnia symptoma penitus evanuerunt. Febres non amplius apparuerunt per proximos sex menses, regulariter – quod reprehendo.
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.