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Urticarial vasculitis (UV) may have been described for the first time in 1973 at the Mayo Clinic by a team that included a dermatologist. The initial description was of what the authors termed “hypocomplementemic urticarial vasculitis” (HUV), which perhaps represented a much rarer variant than what has subsequently been termed UV. In the mid-1990s, HUV was linked to early-onset emphysema. These authors defined UV as urticarial lesions lasting longer than 24 hours with leukocytoclastic vasculitis demonstrated on biopsy. They retrospectively compared 21 patients, including 2 children who did not have a skin biopsy, with 745 patients whose vasculitis did not manifest as urticarial lesions.
The only meaningful clinical differences in the UV pati…