Hemorrhagic urticaria with pseudoarthritis.

Abstract

Urticaria is an inexhaustible source of diagnostic errors (1). Urticaria, bruising and arthritis are associated in Henoch-Schoenlein disease and in some autoinflammatory diseases such as CINCA and Schnitzler syndrome (2). In all these conditions there are other clinical signs and laboratory tests show obvious abnormalities. On the other hand, both in hemorrhagic urticaria and urticaria with pseudoarthritis there are no other symptoms ; moreover, laboratory tests do not show significant changes. Bruising in urticaria is due to excessive vasodilation with extravasation of red blood cells through a no longer continent endothelium. Moreover, edema occurring in periarticular skin can result in functional impairment and joint pain. The absence of other symptoms and objective signs and especially the rapid disappearance of symptoms with the regression of edema facilitates the diagnosis.