Lichturtikaria: Klinik, Diagnostik, Verlauf und Therapiemanagement bei 27 Patienten.

Autor: Gaebelein-Wissing N; Zentrums für Dermatologie, HELIOS Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal., Ellenbogen E; Department of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, Israel., Lehmann P; Zentrums für Dermatologie, HELIOS Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal.
Jazyk: němčina
Zdroj: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG [J Dtsch Dermatol Ges] 2020 Nov; Vol. 18 (11), pp. 1261-1269.
DOI: 10.1111/ddg.14309_g
Abstrakt: Background and Objectives: Solar urticaria is a rare photodermatosis, yet lacking standardization in diagnosis and therapy. The aim of this research was to use innovative radiation sources for diagnostics with defines and reproducible emission spectrum and doses. A uniform therapy step scheme was to be created.
Patients and Methods: In a longitudinal study, 27 patients were examined with solar urticaria over 13 years. With a characteristic anamnesis, the diagnosis was confirmed with phototesting from various radiation sources (UVB, UVB311nm, UVA, UVA1, green light, red light) and a therapy step scheme consisting of light protection, antihistamines, rush hardening with UVA-1 and the treatment with omalizumab.
Results: Action spectrum: UVB 44 %, UVA 70 %, UVA1 89 %, green light 37 % and red light 22 %. Rush hardening was performed on 20 patients, 17 of whom were adequately protected. In three further patients, omalizumab was additionally treated in off-label use.
Conclusions: Photoprovocation with UVB, UVB311nm, UVA, UVA-1 and visible light with innovative radiation sources is uniformly possible in every major skin clinic. With the help of the therapy step scheme the patients can be adjusted well, a Rush Hardening with UVA-1 is a safe method to help the patients during the sunny season. Omalizumab as the last therapy option is effective, but currently only possible in off-label use.
(© 2020 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.)
Databáze: MEDLINE
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