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Noemi Gaebelein-Wissing1, Eran Ellenbogen2, Percy Lehmann1

  • 1Zentrums für Dermatologie, HELIOS Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|November 30, 2020
PubMed
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This study introduces standardized diagnostic methods and a tiered treatment approach for solar urticaria, a rare skin condition. Innovative light sources and therapies like rush hardening and omalizumab improve patient management.

Area of Science:

  • Dermatology
  • Photobiology

Context:

  • Solar urticaria is a rare photodermatosis lacking standardized diagnostic and therapeutic protocols.
  • Current diagnostic methods and treatments for solar urticaria are inconsistent across clinical settings.

Purpose:

  • To establish standardized diagnostic criteria for solar urticaria using novel radiation sources with defined emission spectra and doses.
  • To develop a uniform, step-by-step therapeutic scheme for managing solar urticaria.

Summary:

  • A 13-year longitudinal study examined 27 solar urticaria patients using phototesting with various light sources (UVB, UVA, UVA1, green, red).
  • A therapeutic protocol included light protection, antihistamines, UVA1 rush hardening, and omalizumab.
  • Action spectra identified UVA1 (89%) as most effective, followed by UVA (70%) and UVB (44%). Rush hardening successfully treated 17 of 20 patients, with omalizumab effective in off-label use for three others.

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Impact:

  • Standardized photoprovocation using innovative radiation sources is feasible in clinical practice.
  • The developed therapy step scheme, including UVA1 rush hardening, effectively manages solar urticaria patients.
  • Omalizumab demonstrates efficacy as a last-resort treatment for solar urticaria, though currently off-label.