Urticarial dermatitis: a nosological dilemma

Abstract

Dear Editor, Significant progress has been made in defining urticarial dermatitis since its first description in 2006, but the exact nature of the condition remains elusive. Kossard and coauthors, in their seminal description, outlined clinical and histologic definitions: urticarial papules and plaques lasting more than 24 hours associated with eczematous features represents clinical urticarial dermatitis, while the dermal hypersensitivity reaction pattern of upper dermal perivascular lymphocytic infiltration with eosinophils and minimal epidermal change defines histologic urticarial dermatitis.1 The definition of a disease serves the purpose of identifying a group of patients with some shared attribute, be it a similar or predictable natural history, prognosis, or response to therapy. However, whether the intersection between clinical and histologic urticarial dermatitis defines such a group has yet to be established.