Abstract
HISTORY OF PRESENT ILLNESS This child was referred to the Pediatric Allergy and Immunology clinic by her pediatrician for evaluation of repeated episodes of “solar urticaria” which had been recurring over the past 3 years. These episodes of pruritus, swelling, and burning of the face, arms and legs would usually begin in the late spring when the child started to play outside. Every episode had developed within minutes of sun exposure and symptoms were never present in sun protected sites of her body. No symptoms occurred if the weather was overcast or in the winter. She denied any trouble breathing or swallowing during these episodes. There was no fever, fatigue, blistering of the skin, or joint pain. The episodes of urticaria had not been associated with use of any medications including nonsteroidal anti-inflammatory medications or antibiotics. Over the past 3 years, she had seen multiple physicians regarding this problem including allergists and dermatologists. Previous allergy skin testing was negative. Previous trials of diphenhydramine, as well as topical and oral corticosteroids did not provide relief. A variety of sunblocks had been used repeatedly without any improvement in the symptoms. The past medical history was significant for treatment with intravenous gammaglobulin when she was 12 months old for “septicemia.” There was a family history of atopy but no relatives with a specific history of photosensitivity or urticaria.
Published Version
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