title: Late-phase urticaria Update.
abstract: 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.
authors.affiliation: Department of Dermatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Japan. nkambe@kuhp.kyoto-u.ac.jp
authors.forename: Naotomo
authors.initials: N
authors.lastname: Kambe
authors.forename: Aki
authors.initials: A
authors.lastname: Kitao
authors.forename: Chikako
authors.initials: C
authors.lastname: Nishigori
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Miyachi
mesh_terms: D004804:Eosinophils / Q000276:immunology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000150:complications / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000276:immunology; D011312:Pressure / Q000009:adverse effects; D013997:Time Factors; D014581:Urticaria / Q000209:etiology* / Q000276:immunology; D014657:Vasculitis / Q000150:complications