Urticarial vasculitis: An unusual manifestation of ‘rhupus’

Prashant Kaushik, Stephen Bastilbe, Matthew Gibson, Jana Baker

Research output: Contribution to journalArticlepeer-review


A 43-year-old kind lady presented to the clinic for rheumatological evaluation for chronic worsening joint pain and associated morning stiffness with family history of rheumatoid arthritis (RA) in her father and a daughter who is HLA-B27 positive. After initial clinic presentation, the patient was hospitalized for acute onset of a truncal skin rash which after biopsy was identified as being secondary to urticarial vasculitis (UV). Management consisted of oral methotrexate with discontinuation of previously initiated hydroxychloroquine (HCQ). While UV alone is not pathognomonic for lupus, patient-presentation both clinically and laboratory-wise favored systemic lupus erythematosus (SLE) (especially with presence of hypocomplementemia for C4) along with early rheumatoid arthritis(14.3.3η positivity), an overlapping condition also known as ‘rhupus’.
Original languageAmerican English
JournalOklahoma State Medical Proceedings
Issue number2
StatePublished - 12 Dec 2022


  • rhupus
  • rheumatoid arthritis
  • systemic lupus erythematosus
  • urticarial vasculitis


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