Clinical characteristics and treatment outcomes in patients with urticarial vasculitis

OBJECTIVE: Urticarial vasculitis (UV) is an uncommon disease clinically presenting with pruritic urticarial plaques of the skin. The disease is classified as normocomplementic and hypocomplementemic types according to their complement levels. We aimed to evaluate demographic characteristics, laboratory findings, and response to treatment of patients diagnosed as UV in our clinic.
METHODS: Between January 2015 and January 2019, the files of the patients were retrospectively reviewed. Demographic data, clinical features, laboratory findings, suspected triggering factors, disease course, treatment modalities, and treatment results of the patients were recorded.
RESULTS: A total of 16 patients (nine males [56.25%], seven females [43.75%]) were included in the study.The mean age at diagnosis was 45.2±10.4 years and the duration of the disease was 72.1±62 months. Twelve (75%) patients had angioedema and two (12.5%) patients had residual hyperpigmentation. The most common extracutaneous finding was arthralgia (43.7%). No hypocomplementemia was detected in the patients. The most common abnormal laboratory findings were CRP elevation (37.5%) and ANA positivity (n=4/15, 26.7%). Analgesic and antibiotic drugs use were the most common possible triggering factors for the disease (n=9, 56%). Oral antihistamines, oral corticosteroids, azathioprine, colchicine, dapsone, hydroxychloroquine, doxepin, and omalizumab were among the treatments given to the patients. Complete remission was achieved in three patients.
CONCLUSION: Compared with other studies, we found that angioedema was more frequent, postinflammatory hyperpigmentation was lower and long-term treatment was needed to control UV attacks. There are a few studies on UV and we think that more and larger patient groups are needed for standardization of treatment.

Ürtiker Vaskülitli Hastalarda Klinik Özellikler ve Tedavi Sonuçlarý

Amaç Ürtikeryal vaskülit (ÜV), deride kaþýntýlý ürtikeryal plaklar ile ortaya çýkan nadir bir hastalýktýr. Hastalýk kompleman seviyesine göre normokomplemantemik ve hipokomplemantemik tip olarak sýnýflandýrýlýr. Kliniðimizde ÜV tanýsý almýþ olan hastalarýn demografik özelliklerini, laboratuvar bulgularýný ve tedaviye yanýtlarýný deðerlendirmeyi amaçladýk.
Yöntemler Ocak 2015-Ocak 2019 tarihleri arasýnda hastalarýn dosyalarý geriye dönük olarak incelendi. Demografik veriler, klinik özellikler, laboratuar bulgularý, þüpheli tetikleyici faktörler, hastalýðýn seyri, tedavi yöntemleri ve tedavi sonuçlarý kaydedildi.
Bulgular Çalýþmaya toplam 16 hasta [9 erkek (%56.25), 7 kadýn (%43.75)] dahil edildi. Taný sýrasýndaki ortalama yaþ 45.2±10.4 yýl ve hastalýk süresi 72.1±62 ay idi. On iki (%75) hastada anjioödem ve iki (%12.5) hastada rezidüel hiperpigmentasyon vardý. En sýk saptanan deri dýþý bulgu artralji (%43.7) idi. Hastalarda hipokomplemantemi saptanmadý. En sýk görülen anormal laboratuvar bulgularý CRP yüksekliði (%37.5) ve ANA pozitifliði (n = 4/15, %26.7) idi. Analjezik ve antibiyotik ilaç kullanýmý hastalýk için en olasý tetikleyici faktörlerdi (n = 9, %56). Hastalara veriler tedaviler içerisinde oral antihistaminler, oral kortikosteroidler, azatiopurin, kolþisin, dapson, hidroksiklorokin, doksepin ve omalizumab yer almaktaydý. Üç hastada tam remisyon saðlandý.
Sonuç Diðer çalýþmalar ile karþýlaþtýrýldýðýnda anjioödem varlýðýný daha sýk, postinflamatuar hiperpigmentasyonun ise daha düþük olduðunu ve ÜV ataklarýnýn kontrolü için uzun süreli tedaviye ihtiyaç olduðunu saptadýk. ÜV konusunda yapýlmýþ çalýþma sayýsý oldukça azdýr ve tedavinin standardizasyonu için daha fazla sayýda ve daha geniþ hasta gruplarý ile çalýþmaya ihtiyaç olduðunu düþünmekteyiz. (NCI-2019-0281.R1)