Refractory Urticarial Vasculitis Responsive to Methotrexate: Could It Be a New Treatment Option?

Objective: Urticarial vasculitis is a chronic clinicopathologic entity characterized by clinically characterized urticarial rash, histopathologically characterized by leukocytoclastic vasculitis. The pathogenesis is thought to be developed by a type III hypersensitivity reaction similar to leukocytoclastic vasculitis. Methods: Antihistamines and/or corticosteroids (systemic/local) may be used in patients with limited normocomplementemic urticarial vasculitis. In the literature, severe cases treated with dapsone, colchicine, hydroxychloroquine, pentoxifylline, omalizumab, mycophenolate mofetil, rituximab, cyclosporine, intravenous immunoglobulin, and cyclophosphamide have been reported in the case reports. Results: In this case, the patient, whose symptoms had not previously responded to treatment with antihistamines, steroids, cyclosporine, and omalizumab, responded to treatment with methotrexate. Conclusion: This case report recommends that methotrexate therapy may be a treatment option for cases of resistant urticarial vasculitis.