Kambe Naotomo, Kitao Aki, Nishigori Chikako, Miyachi Yoshiki
Department of Dermatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Japan.
Curr Allergy Asthma Rep. 2002 Jul;2(4):288-91. doi: 10.1007/s11882-002-0052-8.
In ordinary urticaria, individual lesions disappear within 24 hours. However, we sometimes encounter patients whose eruptions last longer than 24 hours, but without evidence of vasculitis or a history of exposure to pressure. In these patients, histology reveals a perivascular infiltration, predominantly of eosinophils, depending on the timing of the biopsy. Unlike urticarial vasculitis, no immunoglobulins, complement deposition, or endothelial fibrinoid degeneration is observed. The peripheral eosinophil counts and serum complement levels appear within normal range. No protein urea or joint pain is observed, and the lesions can be controlled only by systemic glucocorticoids. We recognize such a urticarial reaction as a different clinical entity than usual urticaria, which is presumably mediated by late-phase inflammatory reaction in immediate hypersensitivity.
在普通荨麻疹中，单个皮疹在24小时内会消退。然而，我们有时会遇到皮疹持续超过24小时的患者，但无血管炎证据或受压史。在这些患者中，根据活检时间不同，组织学检查显示血管周围浸润，主要为嗜酸性粒细胞浸润。与荨麻疹性血管炎不同，未观察到免疫球蛋白、补体沉积或内皮纤维蛋白样变性。外周嗜酸性粒细胞计数和血清补体水平在正常范围内。未观察到蛋白尿或关节疼痛，且皮疹仅能通过全身性糖皮质激素得到控制。我们认识到这种荨麻疹反应是一种与普通荨麻疹不同的临床实体，推测是由速发型超敏反应中的迟发性炎症反应介导的。
