What is Urticarial dermatitis?
Urticarial dermatitis is a very pruritic skin lesions mimic urticaria but persist for more than 24 hours and may be associated with eczematous lesions. Lichenification and excoriation from rubbing and scratching is commonly seen in affected areas
What are the most affected sites?
- Urticarial dermatitis lesions usually involve the trunk and proximal extremities.
Who are more affected with urticarial dermatitis?
- It often occurs in the elderly more than 50 years.
What are the conditions that may present as urticarial dermatitis?
- Scabies.
- Prodromal bullous pemphigoid.
- Allergic contact dermatitis.
- Hypersensitivity drug reaction.
- Occult malignancy.
What are the treatment options ?
- Exclude and treatment of the conditions that may present as urticarial dermatitis.
- Systemic steroids
- Prednisone: start with 40 mg per day and then tapered over 4 to 8 weeks.
- Triamcinolone IM single 40 mg injection every 6 to 12 weeks ( 3-4 times).
- Dapsone.
Recurrence may occur on steroid discontinuation, it is recommended to add immunosuppressive agent before steroid discontinuation.
- Systemic immunosuppressive
- Mycophenolate mofetil : 30 to 40 mg/kg per day in two divided doses, at least two months and then corticosteroids are discontinued, then after 2 months without recurrence, you can start to taper Mycophenolate 500 mg per day every 2 to 3 months.
- Methotrexate : a weekly dose of 10 to 15 mg with the lowest dose of corticosteroids, then steroid should be stopped, if no relapse happens within 4 weeks, methotrexate should be tapered by 2.5 mg per week every 2-3 weeks.
- Cyclosporine : 3 mg/kg per day, start tapering after 2 weeks.
- Azathioprine: 2 to 2.5 mg/kg per day, after 8 weeks of azathioprine and steroids, you can discontinue steroids and taper Azathioprine by 50 mg per day every 2-3 months.
- Phototherapy.
#urticaria #urticaria like lesions #Urticarial dermatitis