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Treatment of refractory solar urticaria with plasma exchange
R Bissonnette1, N Buskard, D I McLean
1Division of Dermatology, University of British Columbia, and Vancouver Hospital & Health Sciences Centre, Vancouver, British Columbia, Canada.
Background:
Solar urticaria is a photodermatosis that can be very disabling for patients who are highly sensitive to light and can also be very resistant to therapy.
Objective:
To correlate the results of serial phototesting in a patient with severe and refractory solar urticaria before and after treatment with plasma exchange.
Methods:
Plasma exchange was performed five times over a period of 10 days. Phototesting to ultraviolet A (UVA) irradiation and visible light was performed with fluorescent ultraviolet tubes and an incandescent lamp.
Results:
The urticaria that developed after very low light doses during baseline phototesting could not be provoked following plasma exchange. The patient is now almost symptom-free, with only occasional and transient hives more than 21 months after her last plasma exchange.
Conclusions:
Plasma exchange is a therapeutic modality to consider in highly light-sensitive patients when other treatments have failed.