Vasculitic urticaria (UV) is a condition characterized by hives lasting more than 24 hours, itchy and burning with residual hyperpigmentation. Histopathology is characterized by leukocytoclastic vasculitis, perivascular infiltrate and fibrin deposits. The incidence is approximately 2%, prevalence in women (5:1). The treatment includes steroids, immunosuppressants, and has suggested the use of monoclonal antibodies. We report a patient treated with omalizumab.
Methods:
Case Report. Female 51 years old, his mother died of complications from Lupus Erythematosus (SLE). 10 years ago was diagnosed with SLE by criteria haematological and immunological joints treated with azathioprine, chloroquine and deflazacort, with control of lupus, immunosuppressive suspended and continuing low-dose steroids. Have hives as secondary reaction to netilmicin and penicillin. Two years ago shows like lesions papules and burning and itching rash on chest and limbs, with no peeling hyperpigmented macules, managed with systemic steroids (prednisone) and antihistamines, with a decrease of the same but has l month after similar injuries, and macula, adjust the dose of steroid 1 mg / kg with a decrease in events with exacerbations and remissions, until 3 months course again with increasing symptoms with erythematous, violaceous, painful to the touch did not disappear in extremities lower, upper abdomen and chest, with no improvement after systemic steroids, antihistamines, and immunosuppressants, laboratories report 4.600 leukocytes, eosinophils 100/mcl, 90.1mgU/dl C3, C4 8.6mg/dL of 169 IU IgE / ml, leukocytoclastic vasculitis biopsy reports, deciding Omalizumab use was calculated based on weight and IgE, showing significant improvement with disappearance of the lesions, without pain or itching with hives.
Results:
Gradual decrease was observed of Score of 6 to 1, and score-related quality of of life with a 84.37 to 42.36 CUQ2oL after 3 applications, with a significant P by comparing the results and statistical analysis
Conclusions:
We conclude that Omalizumab may be useful in the treatment of vasculitic urticaria, although it requires clinical trials that include a greater number of patients and be compared with conventional treatment