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Urticarial vasculitis is a multisystem disease characterized by cutaneous lesions resembling urticaria, except that wheals persist more than 24 h, generally up to 3 to 4 days. Fever, arthralgia, elevated sedimentation rate, and histologic findings of a leukocytoclastic vasculitis are also present. The syndrome is often accompanied by various degrees of extracutaneous involvement. May be cutaneous manifestations of SLE.


Causes:

Thought to be an immune complex disease, similar to hypersensitivity vasculitis. Deposition of antigen-antibody complexes in cutaneous blood vessel walls leads to complement activation, resulting in neutrophil chemotaxis; collagenase and elastase released from neutrophils cause vessel wall and cell destruction.


Symptoms:

The first symptom of urticarial vasculitis is an urticarial eruption that is often painful or has a burning sensation. In some cases there may be pruritus (itching). Lesions are red patches that may have a white centre and petechiae (small spots of bleeding under the skin) may appear. Lesions usually last for more than 24 hours in a fixed location after which they will slowly resolve spontaneously. Ecchymoses (bruise-like patches) or hyperpigmentation (darkening of the skin) may occur in the healing process.

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