Assessment of demographic features, clinical characteristics and dermoscopic and laboratory findings of chronic urticaria

Chronic urticaria is a rather common skin disorder characterized by recurrent occurence of short-lived wheals with or without angioedema for more than 6 weeks. Although identification and elimination of the etiopathogenic and/or trigger factors is the most desirable treatment approach, a specific precipitant factor can not be identified in more than 80% of patients. Instead of routine and screening tests, it?s recommended that laboratory investigations should be designed on the basis of history and physical examination findings. However, the fear of the clinician that the patient may not be satisfied or missing severe, underlying disease, detailed laboratory tests are still performed.Urticarial vasculitis is a clinicopathologic entity characterized by recurrent urticarial attacks and histopathological evidence of leukocytoclastic vasculitis. Differentiation between common urticaria and urticarial vasculitis is crucial and essential because etiology and treatment options differ from each other. Lately, using dermoscopy as a screening test in the clinical differentiation between common urticaria and urticarial vasculitis has been a current issue.The aim of this study was to assess the efficiency and exingency of history, clinical findings and laboratory tests which are routinely performed in detection of etiological factors of chronic urticaria as well as identifying the role of dermoscopy in discrimination between common urticaria and urticarial vasculitis.Fifty-two adult patients with urticarial symptoms for more than 6 weeks were included in this study. A diagnostic protocol which included detailed history taking, physical examination and laboratory tests were performed for all patients and 30 patients except for physical urticaria, cholinergic urticaria and angioedema without urticaria patients were also evaluated for dermoscopic findings.In our study, statistical significant difference has not been found between dermoscopic features of common urticaria and urticarial vasculitis patients. This finding suggests that dermoscopy is not useful for discrimination of common urticaria and urticarial vasculitis in daily practice.In our study, we observed that abnormal laboratory findings were substantially coincidental and irrelevant to urticaria itself. This finding indicates that in patients with chronic urticaria or angioedema, diagnostic workup should be perfomed based on detailed history and physical examination.