Real-life experience in the treatment of solar urticaria: retrospective cohort study.
Clin Exp Dermatol
; 44(5): e164-e170, 2019 Jul.
Article
in En
| MEDLINE
| ID: mdl-30828851
ABSTRACT
BACKGROUND:
Solar urticaria (SU) is a rare photodermatosis causing a significant impact on patients' quality of life (QoL), and treatment is often challenging.AIM:
To analyse clinical experience with a tailored stepwise therapeutic approach.METHODS:
A retrospective cohort design was used. Patients with suspected SU underwent laboratory investigations and photoprovocation. Those with a high minimal urticaria dose (MUD) were treated with a single antihistamine (protocol 1), and those with a lower MUD received three types of antihistamines (protocol 2); both protocols included a leucotriene receptor antagonist (LRA). In cases of failure, treatment was switched to omalizumab at doses of < 300 mg/month with incremental dosage increases as necessary (monthly dose range, 150-600 mg/month). Symptom relief and photoprovocation under treatment were evaluated.RESULTS:
In total, 30 patients (10 men, 20 women) were enrolled. Most (87%) were sensitive to visible light (1-70 J/cm2 ) with or without extension to ultraviolet A. Of the 30 patients, 23 opted for our stepwiseapproach:
22 achieved complete remission on protocols 1 or 2 (n = 17) or after switching to omalizumab (n = 5), and another patient achieved partial remission under omalizumab. There were no treatment-related severe adverse effects.CONCLUSIONS:
Symptoms of SU can be well controlled by treatment with antihistamines and an LRA tailored to the degree of photosensitivity, followed by omalizumab in refractory cases. This has important implications for patient QoL.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Photosensitivity Disorders
/
Urticaria
/
Anti-Allergic Agents
/
Leukotriene Antagonists
/
Omalizumab
/
Histamine Antagonists
Type of study:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Clin Exp Dermatol
Year:
2019
Document type:
Article
Affiliation country:
Israel