Plasma exchange therapy for solar urticaria

Abstract

We report two cases of severe idiopathic solar urticaria treated with plasma exchange therapy. Previous treatment which included antihistamines and, in one patient, desensitization with psoralens and ultraviolet A (PUVA) and narrowband ultraviolet B phototherapy produced only partial benefit. The effect of plasma exchange therapy was assessed using monochromator phototesting and intradermal injection of in vitro irradiated serum. One patient responded but relapsed within 2 weeks. We have failed to demonstrate a lasting benefit from plasma exchange therapy (PExT) in the treatment of two patients with idiopathic solar urticaria.

Solar urticaria

“…[99][100][101] Combined treatment with plasmapheresis and psoralen plus UVA phototherapy (PUVA) in patients with circulating photoallergens has resulted in partial remission. 102 Mang et al 103 reported successful treatment of solar urticaria with extracorporeal photopheresis.…”

Immunologically Mediated Photodermatoses

“…UV-protective clothes for which compliance with the EN13758 is claimed must fulfill all stringent instructions of testing, classification, and marking, including a UPF >40 (UPF 40+), average UVA transmission <5%, and specific design requirements as specified in part 2 of Table IV. Therapeutics in immunologically mediated photodermatoses Therapy PLE [19,[50][51][52] Hydroa vacciniforme [2,28,50] Solar urticaria [38,51,[53][54][55][56][57] Actinic prurigo [2,24,51,58,59] Chronic actinic dermatitis [32,54,60,61] the standard. [62] Nevertheless, in patients with severe photosensitivity (e.g.…”

“…azathioprine, mycophenolate mofetil, and calcineurin inhibitors, such as cyclosporine [ciclosporin] and tacrolimus) approaches are more frequently used in severe cases of actinic prurigo, solar urticaria, and or chronic actinic dermatitis. [48,[54][55][56][57][58][59][60][61]72,[75][76][77] …”

Physical urticaria

“…This modality has been reported to improve symptoms in the few patients included in these studies. One study failed to demonstrate a lasting benefit with plasmapheresis [92]. The effectiveness of this therapy may depend on the characteristics of the specific photoallergen at work (ie, circulating antigen versus cutaneous antigen).…”