D-Dimer Defects in Histopathologically Proven Urticarial Vasculitis

Section: Research Paper
Issue
Vol. 48 No. 1 (2026): Volume 48 Issue 1
Pages
38-42

Keywords:

Coagulation, D-Dimer, Urticarial Vasculitis, Histopathology

Abstract

Background: Urticarial vasculitis (UV) is an uncommon form of chronic urticaria characterized by urticarial lesions that persist more than 24 hours. Differentiating UV from chronic spontaneous urticaria remains difficult due to overlapping clinical pictures. Recent studies suggest that activation of the coagulation cascade, reflected by elevated serum D-dimer levels, may contribute to disease pathogenesis and morbidity.


Aim: To assess serum levels of D-dimer in urticarial vasculitis patients and evaluate their association with histopathological findings.


Methods: A retrospective case control study was conducted in Mosul, Iraq, between June 2022 and January 2025. Fifty patients clinically diagnosed with urticarial vasculitis were included. Serum D-dimer levels were measured using quantitative ELISA during disease exacerbations. All patients underwent skin biopsy with histopathological examination. Demographic, clinical, laboratory, and pathological data were analyzed. A control group of 50 dermatology patients without vasculitis was included for comparison.


Results: The mean age recorded for the patients was 36.4 ± 9.1 years with female predominance (1.8:1). Elevated D-dimer levels were detected in 80% of UV patients and were significantly higher than controls. Histopathology confirmed leukocytoclastic vasculitis in all cases, with fibrinoid necrosis observed in 88% of biopsies. Elevated D-dimer concentrations showed a significant association with increased histopathological severity, particularly fibrinoid necrosis and endothelial swelling. A positive correlation was found between D-dimer levels and clinical disease activity.


Conclusions: Urticarial vasculitis is associated with significant activation of the coagulation system. Serum D-dimer appears to be a useful predictive marker for disease activity and histopathological severity, supporting its role as an adjunct diagnostic and prognostic indicator alongside skin biopsy evaluation.

References

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Author

Karam Turath Tawfeeq Agha

Department of Pathology, College of Medicine, University of Mosul, Mosul, Iraq

ORCID

Identifiers

DOI: 10.33899/acmm.v48.i1.62270

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1.
D-Dimer Defects in Histopathologically Proven Urticarial Vasculitis. Ann. coll. Med. Mosul [Internet]. 2026 Jun. 30 [cited 2026 Jul. 18];48(1):38-42. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/62270

How to Cite

1.
D-Dimer Defects in Histopathologically Proven Urticarial Vasculitis. Ann. coll. Med. Mosul [Internet]. 2026 Jun. 30 [cited 2026 Jul. 18];48(1):38-42. Available from: https://mmed.uomosul.edu.iq/index.php/mmed/article/view/62270