Local Angioedema following Sun Exposures: A Report of Five Cases

Abstract

Angioedema is a hereditary or acquired disease characterized by localized non-pitting swelling of the subcutaneous tissue which can affect either skin or mucous membranes. Acquired angioedema can often be related to a heterogeneous group of etiological factors including physical stimuli, although up to 38% of cases remain idiopathic. We describe 5 patients who developed an angioedema following sun exposures. All patients reported an intensely stinging angioedema strictly limited to face and extremities, when exposed to solar light. Urticarial wheals were never observed or reported by patients, and oral antihistamines proved to be of no help in preventing or improving the condition of lesions. Laboratory and phototesting data allowed ruling out all other acquired or inherited diseases characterized by photosensitivity. We propose that solar angioedema should be considered a novel clinical entity.

Isolated solar angioedema: A systematic review of the literature

“…Our search yielded 421 citations (Figure 1), dating back to 1961. After exclusion of studies which did not meet eligibility criteria, 3 studies and our present case were included in this review 13‐15 . All studies were case reports or case series (grade C).…”

“…After exclusion of studies which did not meet eligibility criteria, 3 studies and our present case were included in this review. [13][14][15] All studies were case reports or case series (grade C). Of note, we excluded 4 studies which described patients with solar angioedema and erythema (ie not ISA).…”

Solar Angioedema: A report of a patient and a review of literature

“…7 In 2010, Calzavara-Pinton et al proposed solar angioedema as a novel clinical entity after describing five patients with solar angioedema without urticaria; photoprovocation testing in these patients showed UVA as the action spectrum. 8 Although non hereditary angioedema usually responds to antihistamines, solar angioedema typically does not. 8 The reported cases of solar angioedema developed swelling (eyelids and/or lips) minutes to hours after sun exposure.…”

“…8 Although non hereditary angioedema usually responds to antihistamines, solar angioedema typically does not. 8 The reported cases of solar angioedema developed swelling (eyelids and/or lips) minutes to hours after sun exposure. Most patients were controlled with photoprotective measures, but some required IV or oral corticosteroids.…”

“…Bradykinin may be involved in the mechanism of disease, as with other nonhistaminergic cases of angioedema (hereditary, ACE inhibitor induced, idiopathic nonhistaminergic). 8 Solar angioedema, though rare, is important to be recognized as it does significantly affect the quality of life.…”