Systematic review of the clinical characteristics and natural history of solar urticaria

McSweeney, Sheila M; Kloczko, Ewa; Chadha, Mehak; Sarkany, Robert; Fassihi, Hiva; Tziotzios, Christos; McGrath, John A.

doi:10.1016/j.jaad.2023.01.039

Cited by 7 publications

(4 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with solar urticaria exhibit photosensitivity to UVA, visible light and less commonly UVB 4. The proposed pathophysiology is thought to be a type I IgE-mediated hypersensitivity reaction to a photoallergen resulting in mast cell degranulation and an inflammatory cascade 5.…”

Section: Discussionmentioning

confidence: 99%

Overexposure to ultraviolet radiation in solar urticaria

Ross,

Parkin,

Ayer

2024

BMJ Case Rep

View full text Add to dashboard Cite

A man in his 50s was diagnosed with solar urticaria following monochromated light testing that demonstrated exquisite photosensivity to ultraviolet (UV) A, UV B (UVB) and visible light.Treatment options for this photodermatosis are limited; UVB phototherapy is one modality that can be appropriate in some patients. This is administered at very low doses in a controlled environment to induce skin hardening.1To self-treat his condition, the patient used a commercial sunbed on two occasions several days apart. He noted an immediate flare of solar urticaria after first use with associated dizziness. Following the second use, he felt generally unwell and was witnessed to lose consciousness and displayed jerky movements of his limbs while a passenger in a car. Investigations including a head MRI and an EEG were normal; an anoxic seizure caused by a flare of solar urticaria was later confirmed.Solar urticaria is a rare photodermatosis that is poorly understood and difficult to treat. The condition has a significant impact on the quality of life of patients. Severe cases can be associated with systemic symptoms that could be life-threatening.

show abstract

Section: Discussionmentioning

confidence: 99%

Overexposure to ultraviolet radiation in solar urticaria

Ross,

Parkin,

Ayer

2024

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…To our knowledge, this investigation is the most extensive evaluation of FcεRI in patients with SU to date. Previous publications have highlighted that SU symptoms are triggered with the participation of an IgE pathway ( 1 – 3 , 7 ). The association of clinical improvement with lowering FcεRI in omalizumab responders may reinforce the importance in pathophysiology of an IgE type 1 hypersensitivity in SU in real-life clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…However, the precise cromophores that interact with light to form photoallergens, remain unknown. From a clinical perspective, there is still limited knowledge on the clinical features and natural history of SU ( 3 ), which impacts considerably on the quality of life and daily activities of patients ( 4 ). In terms of therapy, it has been proposed that half of CIndU patients are antihistamine-resistant even at higher doses ( 5 ).…”

mentioning

confidence: 99%

Solar Urticaria: An Ambispective Study in a Long-term Follow-up Cohort with Emphasis on Therapeutic Predictors and Outcomes

Pesqué,

Ciudad,

Andrades

et al. 2024

Acta Derm Venereol

View full text Add to dashboard Cite

Solar urticaria is a rare photodermatosis with several unknown pathogenic, clinical and therapeutic aspects. This study analysed the clinical and therapeutic features of a long-term follow-up solar urticaria cohort, with a focus on omalizumab management and outcomes, and characterized omalizumab response with the use of the high-affinity immunoglobulin E (IgE) receptor (FcεRI) and the Urticaria Control Test. An observational, unicentric, ambispective study was conducted from 2007 to 2023. Solar urticaria was diagnosed in 41 patients with a median follow-up of 60 months. Thirteen patients were prescribed omalizumab, with a median treatment time of 48 months. A significant decrease in FcεRI baseline levels and subsequent median increase in Urticaria Control Test was evidenced after omalizumab prescription in all patients. Drug survival at 48 months was at 88.9%. Omalizumab stepping-down protocol led to sustained omalizumab discontinuation in only 1 patient. Median basal Urticaria Control Test was lower (p < 0.01) in patients who were prescribed omalizumab and in patients without remission. This study contributes to our knowledge of omalizumab outcomes in real-life clinical practice and highlights the pathogenic importance of IgE-mediated pathways in solar urticaria, where FcεRI emerges as a possible biomarker of omalizumab response.

show abstract

“…Immediate reaction to light alone is deemed solar urticaria, a type I hypersensitivity reaction (HSR) to a UV-activated endogenous compound within the dermis or serum. 1 , 2 After light testing, photo-allergens are exposed to the back for 24 hours and then irradiated with UV-A. Photoallergic contact dermatitis (PACD) is normally defined as a delayed-type (type IV) HSR upon contact with an exogenous compound, a prohapten, that is activated by UV exposure.…”

Section: Introductionmentioning

confidence: 99%