Successful treatment of solar urticaria by extracorporeal photochemotherapy (photopheresis) – a case report

Authors


Jean Krutmann
Environmental Health Research Institute
at the Heinrich-Heine-University gGmbH
Auf' m Hennekamp 50
40225 Düsseldorf
Germany
Tel:  + 49 211 811 76 27
Fax:  + 49 211 811 88 30
e-mail: krutmann@rz.uni-duesseldorf.de

Abstract

Abstract: Solar urticaria is characterized by erythema and whealing immediately after exposure to ultraviolet radiation and/or visible light. We report about a patient with severe solar urticaria, who was highly sensitive to both UVA radiation and visible light with a Minimal Urticaria Dose (MUD) of 7 J/cm2 UVA. Management of this patient was extremely difficult because standard treatment with oral antihistamines, hardening with UVA, UVB, visible light or oral PUVA and even oral cyclosporin A were completely ineffective. We therefore decided to perform extracorporeal photochemotherapy (photopheresis, ECP). After nine treatment cycles with photopheresis the MUD increased from 7 J/cm2 UVA before treatment to 22 J/cm2 UVA. This hardening effect was associated with a significant decrease of the frequency and severity of whealing and the accompanying symptoms (pain, fatigue, pruritus).

Conclusion: Photopheresis might be of some benefit in selected patients with otherwise intractable solar urticaria.

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