Pathophysiology of Urticarial Vasculitis

Mehregan, Darius; Gibson, Laurence E.

doi:10.1001/archderm.134.1.88

Cited by 50 publications

(23 citation statements)

References 10 publications

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“…The eosinophil can induce tissue damage directly through cytotoxic effects (by releasing reactive oxygen species or eosinophil granule proteins) or indirectly through recruitment and activation of other inflammatory cells. It is recommended that eosinophils can cause UV through production of leukotrienes, increasing vascular permeability and also releasing mediators from mast cells …”

Section: Discussionmentioning

confidence: 99%

Eosinophilic infiltration: an under‐reported histological finding in urticarial vasculitis

et al. 2019

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Background Urticarial vasculitis (UV) is a clinicopathologic entity in which skin lesions resemble urticaria clinically but last more than 24 hours and resolve with residual purpura. In this study, we evaluated distinguishing histological features of UV from common urticaria to differentiate between these two entities. Methods During 1 year, 55 urticaria and 245 UV samples were assessed. The selection criteria for UV included: (1) samples that the histological diagnosis was confirmed by two independent dermatopathologists, (2) the histological diagnosis of UV was inconsistent with the first clinical impression and lesion characteristics. Results Of our 245 UV patients, 96% had endothelial swelling, 18% had red blood cell (RBC) extravasation, neutrophilic infiltration was seen in 46.7%, and perivascular, interstitial, and perineural eosinophilic infiltration in 198 (81.8%), 181 (74.2%), and 118 (48.1%), respectively. Among different histological findings, endothelial cell swelling as well as neutrophil around vessels and eosinophilic infiltrations were statistically different between two groups (P‐value ˂ 0.001). Both urticaria and UV samples showed a predominantly lymphocytic infiltration more than 10 cells per high power field (HPF) (98.2% of urticaria, 98.8% of UV), and only two patients (0.8%) with UV had predominant neutrophilic infiltration (more than 10 cells/HPF). Conclusion We have found that both urticaria and UV showed a predominantly lymphocytic infiltration along with RBC extravasation, endothelial cell swelling, and fibrin deposition in UV. Moreover, significant perineural, perivascular, and interstitial infiltration of eosinophil in UV lesions compared to urticaria was another point that indicates special contribution of these cells in UV pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Eosinophilic infiltration: an under‐reported histological finding in urticarial vasculitis

et al. 2019

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“…26 Eosinophils are likely to play an important role in the development of urticarial vasculitis, producing leukotrienes that can increase vascular permeability and cause further release of chemical mediators from mast cells. 27 Hypocomplementemia is associated with neutrophil-predominant urticarial vasculitis. 7 Often, patients exhibit more systemic symptoms, such as fever, arthralgias, glomerulonephritis, and chronic obstructive lung disease than normocomplementemic patients.…”

Section: J Am Acad Dermatolmentioning

confidence: 99%

Prolonged urticaria with purpura: The spectrum of clinical and histopathologic features in a prospective series of 22 patients exhibiting the clinical features of urticarial vasculitis

Lee

Loh

Seow

et al. 2007

Journal of the American Academy of Dermatology

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“…It is commoner in women than in men and usually presents in the fourth decade of life. 2,19 Typically, the patient with urticarial vasculitis presents with lesions are described as painful, burning and/or pruritic. 18 The lesions tend to demonstrate central clearing or have a dusky discoloration.…”

Section: L I N I C a L C A T E G O R I E Smentioning

confidence: 99%