Abstract
Chronic spontaneous urticaria is the spontaneous appearance of blisters, angioedema, or both for 6 weeks that affects up to 0.5%5% of the population, mainly females. Spontaneous wheals and/or angioedema, severe skin itching that leads to depression and anxiety, sleep disturbances, sexual dysfunction, and activity of daily life and work restrictions. Other diseases sometimes occur under the guise of chronic spontaneous urticaria. Urticarial vasculitis is a vasculitis of the small skin vessels, characterized by the duration of persistent skin rashes in combination with histopathological features of leukocytoclastic vasculitis. Differential diagnosis of chronic spontaneous urticaria and urticarial vasculitis is conducted in the case of an atypical clinical picture of urticaria. Wheals lasted for 24 h, often accompanied by burning and pain, and leaving behind purpura or residual hyperpigmentation. Herein, described a case of urticarial vasculitis in a patient that required a differential diagnosis of chronic spontaneous urticaria and urticarial vasculitis several years after the disease onset. Successful treatment was conducted with a combination of antihistamines, glucocorticosteroids, hydroxychloroquine, and omalizumab.
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