Moffitt AM report PEARLS 11/16: urticarial vasculitis and approach to urticaria and life-threatening rashes

Take-home point from daily ditty: for secondary hypogonadism (low testosterone and low FSH and LH), rule out prolactinemia and hemochromatosis!!

 

Urticarial vasculitis

  • For most patients this is isolated to the skin with some arthralgias and is a self-limited diseas
  • Predominantly involves the skin but can also affect other organs (lungs, kidney, GI)
  • Hypocomplementemia can be associated with extensive vasculitis and systemic features
  • Commonly idiopathic but can be associated with autoimmune disease, drug reactions, infections, or malignancy
  • Treatment: anithistamines (for pruritus), NSAIDs for arthralgias.
    • If moderate, can add steroids with dapsone or colchicine.
    • If severe or refractory with end organ or life-threatening disease, can use mycophenolate mofetil, MTX, azathioprine, cyclosporine

 

Approach to Urticaria

urticaria

(ref: http://www.e-ijd.org/article.asp?issn=0019-5154;year=2011;volume=56;issue=6;spage=622;epage=628;aulast=Sachdeva)

 

And, in my search for more approaches to rashes, here is one based on morphology:

rash

Ref: http://adelaideemergencyphysicians.com/2014/10/a-rash-diagnosis-dermatology-in-ed/

 

Evernote: https://www.evernote.com/shard/s34/sh/cb9b81d5-b410-4d57-85b4-942cca61e2ff/5a3066059d6baab88ff06783d113e3b2

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