荨麻疹性血管炎(UV)是一种难以治疗的疾病,其特征是持久的荨麻疹皮疹和白细胞碎裂性血管炎的组织病理学发现。治疗取决于皮肤和全身受累的严重程度以及潜在的全身性疾病。这是对当前UV治疗选择的功效的全面系统评价。我们在7个数据库中搜索了相关研究,包括MEDLINE,Scopus,和WebofScience。总的来说,261个合格的研究和789个独特的紫外线患者被纳入系统评价。大多数紫外线患者是患有慢性(≥6周)和全身性疾病的成年女性。紫外线主要是特发性的,但可能与药物有关,恶性肿瘤,自身免疫,和感染。它通常会随着他们的戒断或治愈而解决。皮质类固醇可有效治疗超过80%的紫外线患者的皮肤症状。然而,它们的长期服用可能导致潜在的严重不良反应。添加免疫调节或免疫抑制剂通常允许皮质类固醇逐渐减少并提高治疗功效。生物制品,包括奥马珠单抗,以及皮质类固醇,环磷酰胺,氨苯砜,霉酚酸酯,血浆置换,秋水仙碱,羟氯喹,静脉注射免疫球蛋白,非甾体抗炎药,和环孢菌素,对紫外线患者的皮肤和全身症状均有效。H1-抗组胺药,孟鲁司特,达那唑,H2-抗组胺药,己酮可可碱,多塞平,氨甲环酸对大多数紫外线患者无效。到目前为止,没有药物被批准用于紫外线,管理建议主要基于病例报告和回顾性研究。需要前瞻性研究研究治疗对紫外线体征和症状的影响。
Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by the severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic
review of the efficacy of current UV treatment options. We searched for relevant studies in 7 databases, including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique patients with UV were included in the systematic
review. Most patients with UV are adult women with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic but can be associated with drugs, malignancy, autoimmunity, and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of skin symptoms in more than 80% of patients with UV. However, their long-term administration can lead to potentially serious adverse effects. The addition of immunomodulatory or immunosuppressive agents often allows corticosteroid tapering and improves the efficacy of therapy. Biologicals, including omalizumab, as well as corticosteroids, cyclophosphamide, dapsone, mycophenolate mofetil, plasmapheresis, colchicine, hydroxychloroquine, intravenous immunoglobulin, nonsteroidal anti-inflammatory drugs, and cyclosporine, can be effective for both skin and systemic symptoms in patients with UV. H1-antihistamines, montelukast, danazol, H2-antihistamines, pentoxifylline, doxepin, and tranexamic acid are not effective in most patients with UV. As of yet, no drugs have been approved for UV, and management recommendations are based mostly on case reports and retrospective studies. Prospective studies investigating the effects of treatment on the signs and symptoms of UV are needed.