Which medications are used in the treatment of urticarial vasculitis?

Updated: Sep 16, 2020
  • Author: Darius Mehregan, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment of urticarial vasculitis is based on systemic effects of the disease, extent of cutaneous involvement, and previous response to treatment. For patients with cutaneous involvement only, antihistamines or nonsteroidal anti-inflammatory drugs (NSAIDs) may provide symptomatic relief. However, Jachiet et al report that antihistamines were therapeutically ineffective for treatment of hypocomplementemic urticarial vasculitis. [14]

If these agents fail, colchicine, hydroxychloroquine, or dapsone may be effective. If all other treatment modalities have failed or if the patient has systemic involvement, consider initiating treatment with glucocorticoids. If the patient requires long-term treatment with corticosteroids, consider every-other-day dosing of the steroid or the addition of azathioprine as a steroid-reducing agent. Response to newer agents, including mycophenolate mofetil [29, 30] and rituximab, has been reported in the literature. Rituximab-based treatment can provide higher response rates compared with corticosteroids and conventional immunosuppressive agents, which supports its use in relapsing, refractory, or severe disease. [14]

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