Urticaria as a sign of viral hepatitis

Yellow urticaria associated with hepatitis type‐C liver cirrhosis

“…The cause of the yellow urticaria remains unknown, but is speculated to be a possible result of the increased permeability of the blood vessels in the urticaria and the subsequent accumulation of the excess bilirubin in the blood into the surrounding dermis 3–5 . However, as detection of bilirubin in the tissue section by Gmelin staining was negative similar to the previous report, 3 other mechanisms may be involved.…”

“…However, it has also occurred in association with end‐stage non‐viral alcoholic hepatitis 3 . Among only four case reports in which yellow urticaria associated with hepatitis to date, 2–5 there has been only one case that described the exact type of infectious hepatitis; this was type B 4 . We report here the first case of yellow urticaria occurring in a type‐C hepatitis patient.…”

Comorbidity of viral hepatitis and chronic spontaneous urticaria: A systematic review

“…Interestingly, atypical yellow‐colour urticaria has been described in patients with hepatitis C and/or liver cirrhosis . The cause is thought to be hyperbilirubinemia and accumulation of the excess bilirubin in the dermis due to increased vascular permeability . This was confirmed by skin biopsy studies with Hall's staining for bilirubin, which revealed focal deposits of olive‐green crystals .…”

“…Whether CICs are also important in the development of CSU due to CHB/CHC is still unclear. Lockshin and Hurley suggested that the urticarial lesions are induced by antigens from the inflamed liver . These antigens would form CICs and cause degranulation of mast cells via activation of complement and the production of anaphylatoxins.…”