We present a case of hypocomplementemic urticarial vasculitic syndrome (HUVS) who developed severe renal failure requiring ICU-level care. Our patient is a 66-year-old man who presented with abdominal pain, rash, confusion, oliguria, and shortness of breath. He was found to be in acute renal failure with leukocytosis and elevated lactate. Work-up for infectious, autoimmune, and hematologic malignant diseases was negative. The presence of chronic urticaria, abdominal pain, hypocomplementemia, and leukocytoclastic vasculitis on skin biopsy confirmed the diagnosis of HUVS. He required hemodialysis for renal failure as well as gastrostomy tube placement for nutritional support secondary to the development of mucosal ulcers, a rare finding in HUVS. He recovered with several months of high-dose steroids and hemodialysis. This case highlights the effectiveness of steroids for initial treatment of HUVS, and the relapsing and remitting nature of the disease. Providers should also be aware of the broad range of presenting symptoms such as mucosal lesions that may require nutritional support. Interestingly, unlike many previously reported cases of HUVS, our patient had not yet developed signs and symptoms of systemic lupus erythematosus, which often overlaps with HUVS.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China, and caused coronavirus disease-19 (COVID-19), which is still a global pandemic. Dermatologic manifestations have increasingly been identified as significant extrapulmonary manifestations of COVID-19. The dermatologic manifestations associated with COVID-19 infection reported to date include maculopapular rash, vesicular lesions, urticaria-like lesions, and chilblain-like lesions. Knowledge of dermatologic manifestations of COVID-19 may be essential for early diagnosis and a better prognosis in COVID-19 patients. This review summarizes the current understanding of common COVID-19-associated dermatologic manifestations.
Urticaria corresponds to a papular edematous pruriginous fleeting rash on the skin whose cause is most often allergic (food, medicines, insect bites, etc.).Its management is often difficult because of its significant impact on quality of life. Its prevalence is estimated at 0.6% - 1.3% of the general population. Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) or Hansen’s bacillus (BH). Considered as the great simulator leprosy can pose a diagnostic problem with many other dermatological pathologies. This is a 36-year-old patient with a history of chronic urticaria treated with Loratadine 10 mg who consulted the Bamako Dermatology Hospital for a large erythematous cupboard, oedematous fixed on the buttocks evolving for more than 3 days. The interrogation found the notion of pruritus, hives, and physical examination, showed large erythematous plaques, edematous very limited, dark red color, and slightly copper resembling the closet infiltrated by leprosy. The pruriginous nature of the lesions and the absence of other cardinal signs of leprosy allowed us to make the diagnosis of chronic urticaria.
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