Plasmapheresis in Solar Urticaria

Abstract

Three patients with solar urticaria were treated with plasmapheresis. By intradermal injection of in vitro irradiated serum the existence of a circulating photoallergen was demonstrated in cases 1 and 2 but not in case 3. Plasmapheresis induced complete remission of solar urticaria in case 1 and transient improvement in case 2. In case 3, however, no beneficial effect was observed. It is suggested that some patients with solar urticaria, probably those with a circulating photoallergen, may benefit from plasmapheresis.

Effects of Visible Light on the Skin†

“…However, in one of their patients and also in a patient studied by Leenutaphong et al. (38), the urticarial reaction to visible light was inhibited by pre‐exposure and postexposure to UVA, respectively. In addition, augmentation spectrum has also been described in one patient with an action spectrum in the 320–420 nm range; exposure to longer wavelengths (450–500 nm) before exposure to 320–420 nm enhanced wheal formation (34).…”

British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015

“…PUVA has been used in small case series as monotherapy (four patients in one study and six in another), 84,113 in combination with intravenous immunoglobulins (IVIg; single case reports) and with plasmapheresis. [114][115][116] As monotherapy, PUVA was started at either the MPD, based on an erythema reaction without urticaria, or 0Á25 J cm À2 , whichever was lower. 84 Treatments were given three times weekly, with gradually increasing areas of skin exposed to UVA.…”

Ultraviolet radiation and skin mast cells: Effects, mechanisms and relevance for skin diseases

“…The UV action spectrum varies between patients with SU, and it has been suggested that there exist both activating and inhibiting UV spectra, inducing and preventing the wheal formation in SU, respectively . Exposure to inhibiting UV spectrum light may block the binding of the photoallergen to MCs, and there might be a blockade of photoallergen binding to IgE on MCs also during UV‐induced tolerance …”