[Omalizumab for the treatment of severe solar urticaria]

Solar urticaria is a rare condition induced by exposure to ultraviolet radiation. Although it typically resolves spontaneously, like other dermatoses, it often affects patients' quality of life. We report the case of a patient with solar urticaria successfully treated with omalizumab.

A 36-year-old female patient with a history of allergies presented with pruritic wheals in sun-exposed areas for four years. Despite unremarkable physical findings, erythematous-edematous plaques were observed. Serum IgE levels were elevated (507 IU/ml), and antinuclear antibodies and rheumatoid factor were negative. Initial treatment with levocetirizine (up to 20 mg/day) and photoprotection failed, with a UCT score of 10. Omalizumab (300 mg/4 weeks) was added, achieving complete control of the condition (UCT score 16) after five months, allowing for a reduction in the dose and dosing interval. However, episodes during the spring season (UCT score 6) necessitated reintroducing the initial dose to regain full disease control.

Omalizumab is a second-line anti-IgE monoclonal antibody for the off-label treatment of patients who do not respond to systemic antihistamines.