Solar urticaria. Case report and literature review

• Main Authors: María Raigoza, Yuliana Toro, Jorge Sánchez
• Format: Article
• Language: Spanish
• Published: Colegio Mexicano de Inmunología Clínica y Alergia, A.C. 2017-10-01
• Series: Revista Alergia México
• Subjects: Antihistamines; Fotosensibilidad; Urticaria Solar; foto-test.
• Online Access: http://revistaalergia.mx/ojs/index.php/ram/article/view/202

Background: Solar urticaria is a rare type of inducible urticaria characterized by wheal and erythema formation shortly after exposure to sunlight or to an artificial light source; its pathophysiology is not yet entirely understood. The treatment of choice, in addition to exposure avoidance, consists in antihistamine administration. Clinical case: This is the case of a 27-year-old woman with no personal history of allergic diseases and with a 2-year history of erythema and wheals in photo-exposed areas associated with sunlight exposure for periods longer than 10 minutes. A provocation test was carried out; she was started on fexofenadine at 4-fold the standard dose (720 mg/day). Six weeks later, a new challenge was carried out without the antihistamine being discontinued; the reaction was less severe, but she continued with erythema for the first 60 minutes post-exposure. After 3 months on high-dose antihistamines, she referred marked improvement in her quality of life and tolerance to brief sunlight exposure (for less than 15 minutes). Conclusions: Given the knowledge there is about the proposed pathophysiological mechanism for this condition, maybe individuals with solar urticaria could benefit from anti-IgE monoclonal antibody-based therapy.