Yellow urticaria and biliary pancreatitis

INTRODUCTION Urticaria is a common vascular reaction of the skin involving pruritus and transient wheals surrounded by erythema. It results in plasma extravasation into the dermis, because mast cell degranulation and its byproducts, such as histamine, leukotrienes, cytokines, and chemokines, alter vasopermeability. Urticaria appear abruptly, induced by factors that include allergens, infections, autoimmunity, and autoreactivity, and they usually vanish within 24 hours. Yellow urticaria, however, is an uncommon, rarely reported variant characterized by yellow eruptions. Clarke first described yellow urticaria in 1969 in a patient with cold urticaria who had jaundice during infectious hepatitis. Urticaria manifested during the jaundice period, remitting after the hepatitis resolved. Interestingly, despite mild degrees of jaundice detected at more than 2 mg/dL of bilirubin levels, other cases of yellow urticaria did not report an association with jaundice, even in the presence of total bilirubin values ranging from 2.8 to 8.4 mg/dL. Here we report a case of yellow urticaria associated with biliary pancreatitis. The pancreatitis was accompanied by yellow urticaria secondary to dermal bilirubin deposits.