The clinical criteria for the diagnosis of urticarial vasculitis lack accuracy, according to previous studies. The aim of the study was to assess the accuracy of a clinical and a clinical-dermoscopic model for the differential diagnosis of chronic spontaneous urticaria (CSU) and urticarial vasculitis (UV). Dermoscopic images of lesions with histopathologically confirmed diagnosis of CSU and UV were evaluated for the presence of selected criteria (purpuric patches/globules (PG) and red linear vessels). Clinical criteria of CSU and UV were also registered. Univariate and adjusted odds ratios were calculated. Multivariate regression analyses were conducted separately for clinical variables (clinical diagnostic model) and for both clinical and dermoscopic variables (clinical-dermoscopic diagnostic model). 108 patients with CSU and 27 patients with UV were included in the study. The clinical-dermoscopic model notably showed higher diagnostic sensitivity than the clinical approach (63% vs. 44%). Dermoscopic purpuric patches/globules (PG) was the variable that better discriminated UV, increasing by 19-fold the odds for this diagnosis. In conclusion, dermoscopy helps the clinical discrimination between CSU and UV. The visualization of dermoscopic PG may contribute to optimize decisions regarding biopsy in patients with urticarial rashes.

根据先前的研究，诊断荨麻疹性血管炎的临床标准缺乏准确性。这项研究的目的是评估临床和临床皮肤镜模型对慢性自发性荨麻疹（CSU）和荨麻疹性血管炎（UV）的鉴别诊断的准确性。通过组织病理学确认为CSU和UV的诊断的皮损图像被评估是否存在选定的标准（紫癜/小球（PG）和红色线性血管）。还记录了CSU和UV的临床标准。计算单变量和调整后的优势比。对临床变量（临床诊断模型）以及临床和皮肤镜变量（临床皮肤镜诊断模型）分别进行了多元回归分析。该研究包括108例CSU患者和27例UV患者。临床皮肤镜模型显示出比临床方法更高的诊断敏感性（63％比44％）。皮肤镜性紫癜斑块/小球（PG）是可以更好地区分紫外线的变量，该诊断的几率增加了19倍。总之，皮肤镜检查有助于在CSU和UV之间进行临床区分。皮下PG的可视化可能有助于优化关于荨麻疹皮疹患者活检的决策。皮肤镜检查有助于临床区分CSU和紫外线。皮下PG的可视化可能有助于优化关于荨麻疹皮疹患者活检的决策。皮肤镜检查有助于临床区分CSU和紫外线。皮下PG的可视化可能有助于优化关于荨麻疹皮疹患者活检的决策。