Dermatology and Allergology, University Hospital Basel, Basel, Switzerland.
Photodermatol Photoimmunol Photomed. 2011 Dec;27(6):336-7. doi: 10.1111/j.1600-0781.2011.00624.x.
Solar urticaria is a rare photodermatosis probably caused by a chromophore, that - if activated by light of a specific spectrum - binds to mast cell-bound IgE and elicits degranulation. In our patient an action spectrum in ultraviolet A and visible light range was found, in the autologous serum test the presence of a serum chromophore for the same action spectra could be demonstrated, which may underline this pathogenetic hypothesis. Symptoms did not improve using antihistamines and sun protection. Photo hardening was denied from the patient, immunosuppression and plasmapheresis were discussed but not considered. So a treatment with Omalizumab was started that recently was successfully used in 4 case reports. After 3 doses of Xolair® there was no changing in the phototesting results and after 4 doses no subjective improvement.
光线性荨麻疹是一种罕见的光皮病，可能由一种生色团引起，如果这种生色团被特定光谱的光激活，就会与结合在肥大细胞上的 IgE 结合，并引发脱粒。在我们的患者中，发现了一个在中波紫外线和可见光范围内的作用光谱，在自身血清试验中，可以证明存在与相同作用光谱的血清生色团，这可能支持了这一发病假说。抗组胺药和防晒措施都不能改善症状。患者拒绝光致敏，讨论了免疫抑制和血浆置换，但未予考虑。因此，开始使用奥马珠单抗治疗，最近有 4 例病例报告成功使用了这种方法。使用 Xolair® 3 剂后，光试验结果没有变化，4 剂后也没有主观改善。
