Changes of photosensitivity and action spectrum with time in solar urticaria

Ng, Jonathan; Foley, Peter; Crouch, Rohan; Baker, Christopher

doi:10.1034/j.1600-0781.2002.00750.x

Cited by 25 publications

(7 citation statements)

References 16 publications

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“…Although it is accepted that action spectra change over time, little about the subject has been published. [18][19][20] Of the 25 patients who underwent phototesting more than once, the spectra were broadened in 9 and narrowed in 6, suggesting that variation in action spectra with time is common. No literature on prognostic variables has been published.…”

Section: Commentmentioning

confidence: 99%

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Characteristics and Prognosis of Idiopathic Solar Urticaria

Beattie¹,

Dawe²,

Ibbotson³

et al. 2003

Arch Dermatol

144

112

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Background: As little has been published on the course of idiopathic solar urticaria (SU) patients cannot receive comprehensive prognostic advice. Objective: To determine the prognosis and photobiological characteristics of idiopathic SU. Design: Historical cohort study, with inception cohort followed up from time of diagnosis. Follow-up for a median of 4 years (range, 3 months to 26 years) after diagnosis. Setting: Tertiary referral center for the investigation of photodermatoses in Scotland. Patients: The study included 87 patients, 61 (70%) of whom were female, with phototest-confirmed idiopathic SU between 1975 and 2000. Sixty patients (69%) were followed up clinically, and 25 patients (29%) were phototested on 2 or more occasions. Interventions: Investigations at time of diagnosis included monochromator phototesting. Further monochromator phototesting was performed in those patients in whom it was clinically indicated (select subgroup), and all patients who could be traced received a follow-up questionnaire. Main Outcome Measures: Characteristics of SU, responsible wave bands, and prognosis for clinical resolution. Results: The prevalence of idiopathic SU in Tayside, Scotland, is estimated to be 3.1 per 100000. Action spectra were typically broad, with 63% reacting to more than 1 wave band, and the most common provoking wavelengths were the longer UV-A and the shorter visible ones. The majority of subjects were affected perennially (68%), by radiation transmitted through glass (83%) and thin clothing (76%). Coexistent polymorphic light eruption occurred in 20 patients (23%), and another photodermatosis occurred in 6 patients, 3 of whom had chronic actinic dermatitis. In those with SU alone, the mean age at onset was 41 years. The probability of clinical resolution at 5 and 10 years after diagnosis was 0.12 (95% confidence interval, 0.06-0.24) and 0.26 (95% confidence interval, 0.15-0.43), respectively. Conclusion: Idiopathic SU is a chronic disease. The majority of this cohort was still affected after 5 and 10 years.

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Section: Commentmentioning

confidence: 99%

“…17 The action spectrum of SU is usually broad but can vary widely between patients and within an individual over time. [18][19][20] With such heterogeneity, it would appear that a range of chromophores is responsible.…”

mentioning

confidence: 99%

Characteristics and Prognosis of Idiopathic Solar Urticaria

Beattie¹,

Dawe²,

Ibbotson³

et al. 2003

Arch Dermatol

144

112

View full text Add to dashboard Cite

show abstract

“…The activating wavelengths may reportedly vary from time to time with repeated phototesting in a few patients (6–8). The threshold dose to induce urticaria often varies, depending on the test time and the test site of the body.…”

Section: Provocation and Action Spectrum Testsmentioning

confidence: 99%

Solar urticaria–idiopathic?

Horio

2003

Photoderm Photoimm Photomed

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“…Treatment recommendations are based on retrospective studies and small case series. They include broad‐spectrum sunscreens, antihistamines, leucotriene receptor antagonist (LRA), UV phototherapy (hardening), azathioprine, ciclosporin, intravenous immunoglobulins and omalizumab . Some patients have to avoid outdoor activities completely, severely impacting their quality of life and highlighting the importance of effective treatment.…”

Section: Introductionmentioning

confidence: 99%

Real‐life experience in the treatment of solar urticaria: retrospective cohort study

et al. 2019

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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/cm 2 ) with or without extension to ultraviolet A. Of the 30 patients, 23 opted for our stepwise approach: 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 treatmentrelated 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.

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Changes of photosensitivity and action spectrum with time in solar urticaria

Abstract: Significant changes in action spectrum and degree of photosensitivity may occur over years in solar urticaria. However, changes over shorter periods of time are likely to be minor and not have clinical significance.

Cited by 25 publications

References 16 publications

Characteristics and Prognosis of Idiopathic Solar Urticaria

Characteristics and Prognosis of Idiopathic Solar Urticaria

Solar urticaria–idiopathic?

Real‐life experience in the treatment of solar urticaria: retrospective cohort study

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