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.
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.
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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