Urticaria. An immunofluorescence and histopathology study

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Abstract
Fourteen randomly chosen patients with urticaria were studied for the presence of vasculitis, immunoglobulins [Ig] and complement. Results of direct immunofluorescence (DIF) of the involved skin were negative, although 2 patients had Ig and complement [C] demonstrable in the cytoplasm of the epidermal cells. Results of DIF of uninvolved skin were also predominantly negative. Findings from serum samples tested by indirect immunofluorescence (IIF) were negative, except for 1 positive in low titer (1:10, the basement membrane zone). Serum C3 and C4 levels were normal in 5 patients, both levels were low in 2, and the C4 level was low in 1 patient. No skin-reactive Ig were found in these 3 patients by DIF or IIF. The ESR [erythrocyte sedimentation rate] was measured and was elevated in 4 patients. Results of immunofluorescence proved negative in these cases. Of the 12 patients studied by hematoxylin-eosin staining to determine histology, none exhibited vasculitis. Vasculitis with antigen-antibody reactions is apparently not the rule in urticaria.

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