Omalizumab for the treatment of severe solar urticaria
Abstract
BACKGROUND: 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.
CASE REPORT: 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.
CONCLUSION: Omalizumab is a second-line anti-IgE monoclonal antibody for the off-label treatment of patients who do not respond to systemic antihistamines.
ANTECEDENTES: La urticaria solar es una enfermedad poco frecuente, inducida por la exposición a la radiación ultravioleta. Si bien es un cuadro de curación espontánea, al igual que diferentes tipos de dermatosis suele afectar la calidad de vida de los pacientes. Se reporta el caso de una paciente…
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