A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients
Summary 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 an...
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| Veröffentlicht in: | Clinical and experimental dermatology 2009-03, Vol.34 (2), p.166-170 |
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| container_title | Clinical and experimental dermatology |
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| creator | Tosoni, C. Lodi-Rizzini, F. Cinquini, M. Pasolini, G. Venturini, M. Sinico, R. A. Calzavara-Pinton, P. |
| description | Summary
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.
Aims. To diagnose patients with UV histologically and then compare their clinical features and response to various treatment regimens.
Methods. Biopsies were taken from 312 subjects with CU unresponsive to oral antihistamines; of these, 47 were histologically diagnosed as having UV. Biopsies were taken irrespective of the clinical features of weal eruption. Other diseases known to be associated with small‐vessel vasculitis had previously been excluded.
Results. Individual weals lasted |
| doi_str_mv | 10.1111/j.1365-2230.2008.02891.x |
| format | Article |
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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.
Aims. To diagnose patients with UV histologically and then compare their clinical features and response to various treatment regimens.
Methods. Biopsies were taken from 312 subjects with CU unresponsive to oral antihistamines; of these, 47 were histologically diagnosed as having UV. Biopsies were taken irrespective of the clinical features of weal eruption. Other diseases known to be associated with small‐vessel vasculitis had previously been excluded.
Results. Individual weals lasted < 24 h in 57.4% of patients, and pain or tenderness was reported only by 8.6%. Extracutaneous features were present in 81%, hypocomplementaemia in 11% and abnormalities of other laboratory parameters (i.e. raised erythrocyte sedimentation rate, microscopic haematuria) in 76.6%. Hydroxyzine was effective in only one patient. Both oral corticosteroids and cinnarizine were effective in a high percentage of the patients.
Conclusion. This diagnostic approach allowed us to identify a large group (47 patients) with UV. Most did not present the clinical (prolonged duration of weals and bruising) and laboratory features that have previously been described as characteristic of UV. Cinnarizine was found to be a valuable treatment option.</description><identifier>ISSN: 0307-6938</identifier><identifier>EISSN: 1365-2230</identifier><identifier>DOI: 10.1111/j.1365-2230.2008.02891.x</identifier><identifier>PMID: 18681869</identifier><identifier>CODEN: CEDEDE</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adrenal Cortex Hormones - therapeutic use ; Adult ; Aged ; Allergic diseases ; Arthralgia - complications ; Autoantibodies - immunology ; Biological and medical sciences ; Biopsy ; Blood Vessels - pathology ; Child ; Dermatology ; Drug Resistance ; Female ; Fever - complications ; Histamine Antagonists - therapeutic use ; Humans ; Immunity, Cellular ; Immunopathology ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Skin - pathology ; Skin allergic diseases. Stinging insect allergies ; Urticaria - drug therapy ; Urticaria - immunology ; Urticaria - pathology ; Vasculitis - drug therapy ; Vasculitis - immunology ; Vasculitis - pathology</subject><ispartof>Clinical and experimental dermatology, 2009-03, Vol.34 (2), p.166-170</ispartof><rights>2008 The Author(s). Journal compilation © 2008 Blackwell Publishing Ltd</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5011-357f9f04faeb02e82be57c3255f18cc4bfe7e8b482c454bd34172b2ce012dbf3</citedby><cites>FETCH-LOGICAL-c5011-357f9f04faeb02e82be57c3255f18cc4bfe7e8b482c454bd34172b2ce012dbf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21079294$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18681869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tosoni, C.</creatorcontrib><creatorcontrib>Lodi-Rizzini, F.</creatorcontrib><creatorcontrib>Cinquini, M.</creatorcontrib><creatorcontrib>Pasolini, G.</creatorcontrib><creatorcontrib>Venturini, M.</creatorcontrib><creatorcontrib>Sinico, R. A.</creatorcontrib><creatorcontrib>Calzavara-Pinton, P.</creatorcontrib><title>A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients</title><title>Clinical and experimental dermatology</title><addtitle>Clin Exp Dermatol</addtitle><description>Summary
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.
Aims. To diagnose patients with UV histologically and then compare their clinical features and response to various treatment regimens.
Methods. Biopsies were taken from 312 subjects with CU unresponsive to oral antihistamines; of these, 47 were histologically diagnosed as having UV. Biopsies were taken irrespective of the clinical features of weal eruption. Other diseases known to be associated with small‐vessel vasculitis had previously been excluded.
Results. Individual weals lasted < 24 h in 57.4% of patients, and pain or tenderness was reported only by 8.6%. Extracutaneous features were present in 81%, hypocomplementaemia in 11% and abnormalities of other laboratory parameters (i.e. raised erythrocyte sedimentation rate, microscopic haematuria) in 76.6%. Hydroxyzine was effective in only one patient. Both oral corticosteroids and cinnarizine were effective in a high percentage of the patients.
Conclusion. This diagnostic approach allowed us to identify a large group (47 patients) with UV. Most did not present the clinical (prolonged duration of weals and bruising) and laboratory features that have previously been described as characteristic of UV. Cinnarizine was found to be a valuable treatment option.</description><subject>Adolescent</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Allergic diseases</subject><subject>Arthralgia - complications</subject><subject>Autoantibodies - immunology</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Blood Vessels - pathology</subject><subject>Child</subject><subject>Dermatology</subject><subject>Drug Resistance</subject><subject>Female</subject><subject>Fever - complications</subject><subject>Histamine Antagonists - therapeutic use</subject><subject>Humans</subject><subject>Immunity, Cellular</subject><subject>Immunopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Skin - pathology</subject><subject>Skin allergic diseases. Stinging insect allergies</subject><subject>Urticaria - drug therapy</subject><subject>Urticaria - immunology</subject><subject>Urticaria - pathology</subject><subject>Vasculitis - drug therapy</subject><subject>Vasculitis - immunology</subject><subject>Vasculitis - pathology</subject><issn>0307-6938</issn><issn>1365-2230</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE-P1CAYh4nRuOPqVzBc9NbKn1KoiYdNXXdNNnqZrEdC6YsydtoR6Dpz8LtLnXG8SkIg4Xl-vPkhhCkpaV5vNiXltSgY46RkhKiSMNXQcv8Irc4Pj9GKcCKLuuHqAj2LcUMI5VSKp-iCqlrl3azQryscwMQIMW5hTHhyuPfm6zjF5C22wScI3mAz9jhlMP2FfO-nnUnfMjSHjJpMDfjBRDsPPvn4FpscnMIUd2CTfwAc09wfFrWSOJs-B8Xn6IkzQ4QXp_MSrT9cr9vb4u7zzcf26q6wglBacCFd40jlDHSEgWIdCGk5E8JRZW3VOZCgukoxW4mq63lFJeuYBUJZ3zl-iV4fY3dh-jFDTHrro4VhMCNMc9R1rRRlXGRQHUGbB48BnN4FvzXhoCnRS_N6o5eC9VKwXprXf5rX-6y-PP0xd1vo_4mnqjPw6gTkkszgghmtj2eOUSIb1lSZe3fkfvoBDv89gG6v3y-37BdH38cE-7NvwnddSy6F_vLpRov7tr1f3za65b8Bzdewrg</recordid><startdate>200903</startdate><enddate>200903</enddate><creator>Tosoni, C.</creator><creator>Lodi-Rizzini, F.</creator><creator>Cinquini, M.</creator><creator>Pasolini, G.</creator><creator>Venturini, M.</creator><creator>Sinico, R. A.</creator><creator>Calzavara-Pinton, P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200903</creationdate><title>A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients</title><author>Tosoni, C. ; Lodi-Rizzini, F. ; Cinquini, M. ; Pasolini, G. ; Venturini, M. ; Sinico, R. A. ; Calzavara-Pinton, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5011-357f9f04faeb02e82be57c3255f18cc4bfe7e8b482c454bd34172b2ce012dbf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Adult</topic><topic>Aged</topic><topic>Allergic diseases</topic><topic>Arthralgia - complications</topic><topic>Autoantibodies - immunology</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Blood Vessels - pathology</topic><topic>Child</topic><topic>Dermatology</topic><topic>Drug Resistance</topic><topic>Female</topic><topic>Fever - complications</topic><topic>Histamine Antagonists - therapeutic use</topic><topic>Humans</topic><topic>Immunity, Cellular</topic><topic>Immunopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Skin - pathology</topic><topic>Skin allergic diseases. Stinging insect allergies</topic><topic>Urticaria - drug therapy</topic><topic>Urticaria - immunology</topic><topic>Urticaria - pathology</topic><topic>Vasculitis - drug therapy</topic><topic>Vasculitis - immunology</topic><topic>Vasculitis - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tosoni, C.</creatorcontrib><creatorcontrib>Lodi-Rizzini, F.</creatorcontrib><creatorcontrib>Cinquini, M.</creatorcontrib><creatorcontrib>Pasolini, G.</creatorcontrib><creatorcontrib>Venturini, M.</creatorcontrib><creatorcontrib>Sinico, R. A.</creatorcontrib><creatorcontrib>Calzavara-Pinton, P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tosoni, C.</au><au>Lodi-Rizzini, F.</au><au>Cinquini, M.</au><au>Pasolini, G.</au><au>Venturini, M.</au><au>Sinico, R. A.</au><au>Calzavara-Pinton, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients</atitle><jtitle>Clinical and experimental dermatology</jtitle><addtitle>Clin Exp Dermatol</addtitle><date>2009-03</date><risdate>2009</risdate><volume>34</volume><issue>2</issue><spage>166</spage><epage>170</epage><pages>166-170</pages><issn>0307-6938</issn><eissn>1365-2230</eissn><coden>CEDEDE</coden><abstract>Summary
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.
Aims. To diagnose patients with UV histologically and then compare their clinical features and response to various treatment regimens.
Methods. Biopsies were taken from 312 subjects with CU unresponsive to oral antihistamines; of these, 47 were histologically diagnosed as having UV. Biopsies were taken irrespective of the clinical features of weal eruption. Other diseases known to be associated with small‐vessel vasculitis had previously been excluded.
Results. Individual weals lasted < 24 h in 57.4% of patients, and pain or tenderness was reported only by 8.6%. Extracutaneous features were present in 81%, hypocomplementaemia in 11% and abnormalities of other laboratory parameters (i.e. raised erythrocyte sedimentation rate, microscopic haematuria) in 76.6%. Hydroxyzine was effective in only one patient. Both oral corticosteroids and cinnarizine were effective in a high percentage of the patients.
Conclusion. This diagnostic approach allowed us to identify a large group (47 patients) with UV. Most did not present the clinical (prolonged duration of weals and bruising) and laboratory features that have previously been described as characteristic of UV. Cinnarizine was found to be a valuable treatment option.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18681869</pmid><doi>10.1111/j.1365-2230.2008.02891.x</doi><tpages>5</tpages></addata></record> |
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| ispartof | Clinical and experimental dermatology, 2009-03, Vol.34 (2), p.166-170 |
| issn | 0307-6938 1365-2230 |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adolescent Adrenal Cortex Hormones - therapeutic use Adult Aged Allergic diseases Arthralgia - complications Autoantibodies - immunology Biological and medical sciences Biopsy Blood Vessels - pathology Child Dermatology Drug Resistance Female Fever - complications Histamine Antagonists - therapeutic use Humans Immunity, Cellular Immunopathology Male Medical sciences Middle Aged Retrospective Studies Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Skin - pathology Skin allergic diseases. Stinging insect allergies Urticaria - drug therapy Urticaria - immunology Urticaria - pathology Vasculitis - drug therapy Vasculitis - immunology Vasculitis - pathology |
| title | A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients |
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