Solar urticaria successfully treated with intravenous immunoglobulins.
BACKGROUND
Idiopathic solar urticaria (SU) is a rare type of physical urticaria, occurring immediately after exposure to visible or ultraviolet (UV) light. Treatment is based on sun avoidance and on high doses of antihistamines, but is sometimes inefficient.


METHODS
We report on a 41-year-old patient with severe SU who was successfully treated with a single course of 2 g/kg of intravenous immunoglobulins (IVIG).


RESULTS
A dramatic improvement in UVA and UVB tolerance was rapidly observed, with an increase of up to 10 times the UVA minimal urticarial dose on day 3. The treatment with terfenadine was continued. Healing of photosensitivity was persistent since 100 days after the single course of IVIG, no urticarian reaction was provoked with polychromatic irradiation rising above 8.3 J/cm(2) or after UVA doses rising above 15 J/cm(2).


CONCLUSIONS
Use of IVIG in severe SU can be discussed when high-dose antihistamines are inefficient and quality of life is affected.
Maksimovic
Laurent
L
Departement of Dermatology, Hôpital Saint-Louis, Université Denis Diderot Paris VII, Paris, France.
Frémont
Guillemette
G
Jeanmougin
Michel
M
Dubertret
Louis
L
Viguier
Manuelle
M
D000328:Adult; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D010787:Photosensitivity Disorders / Q000188:drug therapy*; D013472:Sunlight / Q000009:adverse effects*; D016593:Terfenadine / Q000627:therapeutic use; D014581:Urticaria / Q000188:drug therapy* / Q000209:etiology
D039563:Histamine H1 Antagonists, Non-Sedating; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D016593:Terfenadine