Urticarial vasculitis

Chronic or recurrent urticarial lesions are common in both primary care and referral medicine. Diagnosis and treatment are usually a challenge for both the patient and the medical practitioner. Most patients are eventually diagnosed with chronic idiopathic urticaria. IgG autoantibody to IgE receptor or IgE itself causes urticarial lesions in 30% of these patients. Only a minority (approximately 10%) of patients with chronic urticarial lesions have urticarial vasculitis. Although some cases are benign, urticarial vasculitis by itself can cause significant morbidity, and it is often a manifestation of a serious illness. Successful diagnosis and treatment of urticarial vasculitis requires careful assessment over time for underlying diseases like systemic lupus erythematosus, hypocomplementemic urticarial vasculitis syndrome, Sjögren's syndrome, and mixed cryoglobulinemia.