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Treatment of solar urticaria using antihistamine and leukotriene receptor antagonist combinations tailored to disease severity
Author(s) -
Levi Assi,
Enk Claes D.
Publication year - 2015
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12186
Subject(s) - antihistamine , antagonist , medicine , leukotriene receptor , leukotriene , pharmacology , dermatology , receptor , immunology , asthma
Summary Background Solar urticarial ( SU ) is characterized by erythema, whealing, and/or pruritus occurring minutes after sun exposure. Treatment is difficult and often unsatisfactory. Objectives To determine the action spectra and minimal urticaria dose ( MUD ) and to tailor a treatment regimen graded according to disease severity in a series of patients with SU . Patients and Methods Eleven patients (seven females, four males, age range: 5–60 years) with a clinical history suggestive of SU , verified by photo‐provocation tests to ultraviolet A ( UVA ), visible light, and/or UVB , were treated with various combinations of antihistamines and leukotriene receptor antagonist. Results All patients were sensitive to visible light (median MUD 50 J/cm 2 ). Three patients were sensitive to UVA (median MUD 3.75 J/cm 2 ), and one patient was sensitive to UVB ( MUD of 0.03 J/cm 2 ). Two patients experienced a spontaneous remission without treatment. One patient declined treatment. The remaining eight patients were managed by a combination of antihistamines (desloratidine, fexofenadine, cetirizine HC l) and a leukotriene receptor antagonist (montelukast). Seven of the 8 patients experienced a sustained remission of symptoms and signs following treatment. Conclusions Photoprovocation for SU with determination of action spectra and MUD enables specifically tailored treatment regimens consisting of combinations of antihistamines and leukotriene receptor antagonist.