Abstract
Solar urticaria is a rare type of photodermatosis that significantly reduces the quality of life of the subjects affected, with a risk of anaphylaxis should the entire body be exposed to the sun. Patients are forced to modify and limit their normal activities, and since the symptoms are triggered by exposure to sun, which is difficult if not impossible to avoid in everyday life, a safe and effective therapy appears to be essential.Unfortunately, traditional therapies in a discrete number of patients are unable to provide adequate and safe answers.We describe the case of an 18-year-old woman who began to manifest the first symptoms walking under the spring sunshine. A few minutes after sun exposure, itching and burning sensation began, followed immediately by erythema appearance in the photoexposed skin areas.She was treated with non-sedating H1-blocking antihistamines and leukotriene antagonist with no success, so we decided to treat with omalizumab.The satisfactory response after the failure of previous standard therapeutic strategies, confirms the effectiveness of this molecule in the treatment of solar urticaria, which despite what reported in several studies, has not yet been recognized and authorized by the competent Health Authorities in the treatment of this condition.
Highlights
Solar urticaria is a rare form of photodermatosis, which commonly occurs within minutes or hours after artificial light irradiation or sun exposure and fades within 24 hours
Solar urticaria is a rare form of physical urticaria and its pathophysiology is still largely unknown, despite the likely significant role played by the mast cells activated by immunoglobulins E [1,2]
Specific IgE antibodies producted against it induces the degranulation of mast cells, resulting in lesions of urticaria
Summary
Solar urticaria is a rare form of photodermatosis, which commonly occurs within minutes or hours after artificial light irradiation or sun exposure and fades within 24 hours. Intensity, and wavelength of irradiation can determine the severity of solar urticaria. All skin types and ethnic groups are affected worldwide with it slightly more common in women than men. It can occur throughout an individuals life span but the mean age of onset is in the fourth decade. The disease can be controlled with phototherapy, antihistamines, leukotriene antagonist, cyclosporin A, intravenous immunoglobulin, or plasmapheresis alone or in combination, in most patients [2,3]. Omalizumab, a recombinant DNA-derived humanized anti IgE monoclonal antibody approved for severe-moderate asthma and chronic idiopathic urticaria, seems to be safe and effective in the treatment of solar urticaria [4]
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