Morioke Satoshi, Moriwaki Masaya, Tanaka Akio, Hide Michihiro
Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Dermatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
J Dermatol. 2025 Feb;52(2):344-347. doi: 10.1111/1346-8138.17480. Epub 2024 Sep 30.
Urticaria is characterized by the development of wheals which usually disappear within a day, and are not present beyond a few days. A 58-year-old man began to develop edematous, partially ring-shaped erythematous lesions accompanied by severe body itching without any particular cause, approximately 2 months before his first visit to our hospital. Each rash emerged as being about 5 mm in diameter, gradually enlarging over several days, and disappeared in up to 10 days. Despite oral treatment with several antihistamines and 10 mg of prednisolone, there was no improvement. Most eruptions disappeared without a trace, but the erythema that appeared on the palms left desquamation. The patient had a history of shellfish allergy, but otherwise no atopic diseases. Drug eruption was ruled out due to a lack of regular taking other medications. Histopathological findings of the skin lesions showed moderate lymphocytic and few eosinophilic infiltrates with edema, but no evidence of vasculitis. Despite the concomitant use of two second-generation antihistamines and montelukast, the rash did not improve. The symptoms began to improve following oral intake of 1.5 mg of betamethasone, which was tapered off with the addition of 150 mg of cyclosporin. The use of all medications was stopped at 4 months from the first visit without recurrence. Wheals of chronic spontaneous urticaria may last for longer than a week without apparent histopathological findings of vasculitis.
荨麻疹的特征是出现风团，风团通常在一天内消失，且不会持续超过几天。一名58岁男性在首次就诊于我院前约2个月开始出现水肿性、部分呈环形的红斑性皮损，并伴有严重的全身瘙痒，无任何特殊原因。每次皮疹出现时直径约5毫米，数天内逐渐增大，最多10天内消失。尽管口服了几种抗组胺药和10毫克泼尼松龙，但病情并无改善。大多数皮疹消退后不留痕迹，但手掌上出现的红斑留下了脱屑。患者有贝类过敏史，但无其他特应性疾病。由于没有规律服用其他药物，排除了药疹。皮肤病变的组织病理学检查结果显示有中度淋巴细胞浸润和少量嗜酸性粒细胞浸润伴水肿，但无血管炎证据。尽管同时使用了两种第二代抗组胺药和孟鲁司特，但皮疹仍未改善。口服1.5毫克倍他米松后症状开始改善，加用150毫克环孢素后逐渐减量。从首次就诊起4个月时停用所有药物，未再复发。慢性自发性荨麻疹的风团可能持续超过一周，且无明显的血管炎组织病理学表现。
