...less medical jargon in a 'Quick Glance' format!
Urticarial Vasculitis is a variant of cutaneous vasculitis. It is characterised by inflamed and reddened patches or weals on the skin that appear to resemble urticaria, but when the skin is examined closely under a microscope, vasculitis is found (inflamed blood vessels).
This disease is generally classified as two types, normocomplementaemic and hypocomplementaemic (normal or lowered levels of complement proteins found on blood testing). Although both types may be associated with systemic symptoms such as angioedema, abdominal or chest pain, fever, and joint pain, this is more apparent in the hypocomplementaemic form. This form has also been linked to the connective tissue disease systemic lupus erythematosus.
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Symptoms:
Hives
Breathing difficulty
Chronic hypocomplementemia
Joint pain
Arthritis
Inflammation of uvea of the eye
Episcleritis
Recurrent abdominal pain
Venulitis of dermid
Glomerulonephritis
Blood in urine
Excess protein in urine
Causes:
The cause is unknown but it has been associated with the following conditions:
Inflammatory connective disorders such as SLE and Sjögren syndrome.
Immunoglobulin disorders such as immunoglobulin A and immunoglobulin M monoclonal gammopathies
Leukaemia and internal cancers
Viral diseases such as hepatitis B, hepatitis C and glandular fever
Drug-induced conditions from ACE inhibitors, penicillin, sulfonamides, fluoxetine and thiazides.
However, the majority of cases arise from no known cause.
Treatment:
Patients with normocomplementaemic urticarial vasculitis usually have minimal or no systemic involvement and lesions often resolve on their own over time.
Treatment is based on systemic effects of the disease and extent of cutaneous involvement. To relieve cutaneous symptoms, antihistamines or non-steroidal anti-inflammatory drugs (NSAIDs) may be used.
Treatments that may be used in the long-term control of severe cases that may be associated with systemic symptoms include:
For cases that are resistant to treatment with corticosteroids other immunosuppressive agents such as azathioprine, cyclophosphamide or ciclosporin may be considered.
