A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients

@article{Tosoni2009ARO,
  title={A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients},
  author={Cinzia Tosoni and Fabio Lodi-Rizzini and Massimo Cinquini and Giorgio Pasolini and M. Venturini and Renato Alberto Sinico and Piergiacomo Calzavara-Pinton},
  journal={Clinical and Experimental Dermatology},
  year={2009},
  volume={34}
}
Background.  Urticarial vasculitis (UV) is an uncommon type of chronic urticaria (CU), which exhibits leucocytoclastic vasculitis. Painful and long‐lasting (> 24 h) weals associated with purpura or bruising are considered indicative of UV. It is often responsive to oral corticosteroids and poorly to oral antihistamines. Hypocomplementaemia and systemic involvement are also commonly reported. 
Chronic spontaneous urticaria or urticarial vasculitis?
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In this report a 10 years old Saudi boy with prolonged urticarial rash, fever, and arthritis is presented and his skin biopsy was consistent with leukocytoclastic vasculitis.
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The results indicate that UV is rare but not exceptional, and in children UV is often preceded by an upper respiratory tract infection.
An approach to the hospitalized patient with urticaria and fever
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The presence of atypical wheals, systemic symptoms such as fever or arthralgia, and a lack of response to antihistamine therapy are important diagnostic clues that should prompt further workup.
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