Urticaria is common in children. Urticarial vasculitis (UV) is a potentially more serious, rare variant. The youngest reported case was 12 months of age. A systemically well, 19-month-old girl presented with her mother who was concerned about the development of a rash. On presentation, the child had normal vital signs, was alert, and was well and playing with toys. There was a widespread urticarial rash (raised, pruritic, and erythematous) that was most apparent on the trunk with minimal rash on the legs. Overlying this urticarial rash in a similar distribution was a blotchy, palpable purpuric rash and associated hyperpigmentation. Investigations revealed a normal level of haemoglobin, white cells, platelets, and electrolytes. Renal function, international normalised ratio, and activated partial thromboplastin time were all normal. There was no blood or protein in the urine. The erythrocyte sedimentation rate was mildly elevated at 19 mm/hour. Complement results (including C1q) obtained later were normal. This case is striking not only because of the rarity of UV in children but also due to the unique diagnostic and prognostic challenges that it raises.
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机译：荨麻疹常见于儿童。荨麻疹性血管炎（UV）是一种可能更为严重，罕见的变异。报告的最年轻病例为12个月大。一名全身健康的19个月大女孩与母亲一起出现，她担心皮疹的发展。出诊时，孩子的生命体征正常，机敏，身体健康，正在玩玩具。有一个广泛的荨麻疹皮疹（凸起，瘙痒和红斑）在躯干上最明显，而腿部皮疹最小。以类似的分布覆盖在荨麻疹上的是斑点状，可触及的紫癜性皮疹和相关的色素沉着。调查显示血红蛋白，白细胞，血小板和电解质水平正常。肾功能，国际标准化比率和活化的部分凝血活酶时间均正常。尿液中没有血液或蛋白质。红细胞沉降速率以19 mm / hour缓慢升高。后来获得的补体结果（包括C1q）是正常的。该病例之所以引人注目，不仅是因为儿童中很少出现紫外线，还因为它引起了独特的诊断和预后挑战。
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