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Clinical and photobiological response in eight patients with solar urticaria under treatment with omalizumab, and review of the literature
Author(s) -
MorgadoCarrasco Daniel,
FustàNovell Xavier,
Podlipnik Sebastian,
Combalia Andrea,
Aguilera Paula
Publication year - 2018
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.12370
Subject(s) - omalizumab , medicine , dermatology life quality index , refractory (planetary science) , dermatology , quality of life (healthcare) , photodermatosis , immunoglobulin e , immunology , antibody , physics , nursing , astrobiology , psoriasis , dna , genetics , xeroderma pigmentosum , dna damage , biology
Summary Background Solar urticaria ( SU ) is a rare photodermatosis. Treatment is challenging, and outcomes are often disappointing. Omalizumab is an anti‐IgE, currently approved for treatment of chronic spontaneous urticaria. We sought to evaluate therapy with omalizumab in refractory SU and describe predictive factors for response. Materials/methods Patients with refractory SU under treatment with omalizumab were included in this study. Clinical outcome was evaluated using the Urticaria Activity Score 7 ( UAS 7), Dermatology Life Quality Index ( DLQI ) and Pruritus Visual Analogue Scale ( VAS ). Complete clinical response ( CCR ) was defined as having an UAS 7 = 0, DLQI <6 and VAS = 0. Phototesting was performed and compared to baseline. We performed a PubMed search to identify reported cases of SU in adults treated with omalizumab, analysing their characteristics in order to predict response to omalizumab. Results Eight patients were included. Median age was 45.5 years (range, 23‐64). Light spectrum most commonly implicated was UV ‐A. Clinical outcomes: 89% (7/8) achieved CCR with omalizumab. Phototesting was normal in 42.8% (3/7) of them. In our review, we identified 38 patients (including the current case series), and 68.4% showed favourable outcomes with omalizumab. Median time since onset of SU was lower in responders. Conclusions Omalizumab can be an effective treatment in refractory SU .