Urticarial vasculitis associated with post-streptococcal disease in children: a case report

Abstract

Background: Urticarial vasculitis (UV) is a rare clinicopathologic, especially among children and infants. Most urticarial vasculitis is caused by unknown etiology. Rarely has it been linked to post-streptococcal disease as a non-suppurative complication of a streptococcus infection. Treatment of urticarial vasculitis can be challenging. It is based on the clinical phenotype, systemic symptoms, and/or underlying diseases. Case Presentation: This study reports a case of a child with an itchy but more painful and burning sensations urticarial lesion which persisted for more than 24 hours, left a residual ecchymotic hyperpigmentation lesion when resolved, and was accompanied by systemic symptoms such as joint pain, fatigue, and gastrointestinal symptoms. The symptoms were preceded by signs of pharyngitis one week before the symptoms and supported by an increase in ASO titer that raised the suspicion of a previous recent streptococcal infection. Skin biopsy revealed a leukocytoclastic vasculitis, a specific finding supporting the diagnosis of urticarial vasculitis. The combination of antibiotics, antihistamines, and corticosteroids gave our case a good clinical response and outcome. Conclusion: A high awareness of urticarial vasculitis linked to post-streptococcal diseases is needed to establish prompt treatment and prevent further complications.