Cribier Bernard
Clinique Dermatologique, University Hospital, Strasbourg, France.
Clin Rev Allergy Immunol. 2006 Feb;30(1):25-9. doi: 10.1385/CRIAI:30:1:025.
Acute urticaria is commonly observed in the prodromic stage of hepatitis A and B infection as well as in hepatitis C infection, although only rare cases have been published regarding the latter. Urticaria is considered one of the pre-icteric symptoms of viral hepatitis and is related to immune-complex deposits; subsequently, it may be associated with arthritis and headache (Caroli's triad). The absence of specific presentation of acute urticaria in patients with viral hepatitis is not surprising because many other viral infections can induce similar cutaneous symptoms. On the other hand, no convincing evidence exists in which hepatitis virus infection caused chronic urticaria. Data are lacking for hepatitis B, but several series and one controlled study showed the absence of a link between hepatitis C and chronic urticaria. Systematic hepatitis virus investigations in patients with chronic urticaria probably are not cost-effective. Hepatitis B or C can occasionally induce urticarial vasculitis, but this is probably related more to vasculitis than to true urticaria.
急性荨麻疹常见于甲型和乙型肝炎感染的前驱期以及丙型肝炎感染中，尽管关于后者仅有罕见病例被报道。荨麻疹被认为是病毒性肝炎的黄疸前期症状之一，且与免疫复合物沉积有关；随后，它可能与关节炎和头痛（卡罗利三联征）相关。病毒性肝炎患者中急性荨麻疹缺乏特异性表现并不奇怪，因为许多其他病毒感染也可诱发类似的皮肤症状。另一方面，尚无令人信服的证据表明肝炎病毒感染会导致慢性荨麻疹。乙型肝炎方面缺乏相关数据，但几个系列研究和一项对照研究表明丙型肝炎与慢性荨麻疹之间不存在关联。对慢性荨麻疹患者进行系统性的肝炎病毒调查可能并不划算。乙型或丙型肝炎偶尔可诱发荨麻疹性血管炎，但这可能更多与血管炎而非真正的荨麻疹有关。
