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childhood to adult , Pt is now 43 yr wt 70 kg Bp. 110 /70 old f chronic urticaria science age 15 yr .on off . in early age control by antihistamine, on off steroid , some time local JADi Buti leaves of forest ? past medi. history. 1yr back have spasmodic cough , relive by motilucast+livoctrizen, MDI inhelor Judiciary,Asthelin, ketotifen . #goitor science age 18 yr age subclinical found after First delivery of a Healthy boy . TSH T4 Normal , IGE High ### ANA normal liver function normal ,ureteric stone removed in past , Oral cavity ,3yr back there is white lining Lican plans , physician treated as fungal infection But not relive , later go in remison it self , it aggravated by spice food that time. Allergy panal for rhinitis, asthma, found ,Dust allergy. not done ....food,drug allergy test till date. urine strile on culture PRESENT TIME PT ON LCZ 10 MY BID MONTAIT LC 10MG OD LAST 1 MONTH, PT HAVE ehhomosis at site of urticaria ,at pressor point. Skin specialist say , Echhomosis is not part of Urticaria , kindly plan , evaluation,dd,

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IT'S A..CASE OF.. SKIN LESIONS.. ? MAST CELL DISORDER.. ? CHRONIC URTICARIA.. ? URTICARIAL VASCULITIS..

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Is this a case of Urticarial Vasculitis ? Provisional clinical URTICARIA VASCULITIS Urticarial vasculitis is a variant of cutaneous small vessel vasculitis. It is characterised by inflamed and reddened patches or weals on the skin that appears to resemble urticaria, but when the skin is examined closely under a microscope, a vasculitis is found. The first symptom of urticarial vasculitis is an urticarial eruption. The lesions are red patches or plaques that may have a white centre, and petechiae may appear. Unlike urticaria, urticarial vasculitis lesions usually last for more than 24 hours in a fixed location, after which they will slowly resolve spontaneously. Ecchymoses or hyperpigmentation may occur in the healing process. Investigations suggested for diagnosis: 1  A skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen. 2 complement level.

Nice explation
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IT'S A..CASE OF.. SKIN LESIONS.. ? MAST CELL DISORDER.. ? CHRONIC URTICARIA.. ? URTICARIAL VASCULITIS..

Tnx Dr Sivaprasdarao Chakka
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* URTICARIAL VASCULITIS ** CHRONIC URTICARIA NEEDS FURTHER INVESTIGATION AND EVALUATION TO CONCLUDE DIAGNOSIS AND TREATMENT PLAN.

Thanks Dr S Chakka.
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Immune system derangement Mast cell disturbance Urticaria Vasculitis

REF: Urticarial vasculitis dermnetnz.org › topics › urticarial-vasculitis Urticarial vasculitis. - NCBI nlm.ncbi.www.nih.gov › pubmed

SUGGESTIVE OF URTICARIAL VASCULITIS DD CHRONIC URTICARIAL RASHES

Urticaria

Food allergy Need to evaluate Serum IG E levels And allergy profile so that you can come to diagnosis of this rash

DD Food allergy Autoimmune disease SLE

Sodhana chikitsa will be helpful. Pathya apathy guidance and nidana parivarjana

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