Treatment of solar urticaria using antihistamine and leukotriene receptor antagonist combinations tailored to disease severity.

Abstract

BACKGROUND:

Solar urticarial (SU) is characterized by erythema, whealing, and/or pruritus occurring minutes after sun exposure. Treatment is difficult and often unsatisfactory.

OBJECTIVES:

To determine the action spectra and minimal urticaria dose (MUD) and to tailor a treatment regimen graded according to disease severity in a series of patients with SU.

PATIENTS AND METHODS:

Eleven patients (seven females, four males, age range: 5-60 years) with a clinical history suggestive of SU, verified by photo-provocation tests to ultraviolet A (UVA), visible light, and/or UVB, were treated with various combinations of antihistamines and leukotriene receptor antagonist.

RESULTS:

All patients were sensitive to visible light (median MUD 50 J/cm(2)). Three patients were sensitive to UVA (median MUD 3.75 J/cm(2)), and one patient was sensitive to UVB (MUD of 0.03 J/cm(2)). Two patients experienced a spontaneous remission without treatment. One patient declined treatment. The remaining eight patients were managed by a combination of antihistamines (desloratidine, fexofenadine, cetirizine HCl) and a leukotriene receptor antagonist (montelukast). Seven of the 8 patients experienced a sustained remission of symptoms and signs following treatment.

CONCLUSIONS:

Photoprovocation for SU with determination of action spectra and MUD enables specifically tailored treatment regimens consisting of combinations of antihistamines and leukotriene receptor antagonist.

• Authors: Assi Levi, Claes D Enk
• Journal: Photodermatology, photoimmunology & photomedicine (Photodermatol Photoimmunol Photomed) Vol. 31 Issue 6 Pg. 302-6 (Nov 2015) ISSN: 1600-0781 [Electronic] England
• PMID: 26052871 (Publication Type: Journal Article)
• Copyright: © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Acetates
• Cyclopropanes
• Histamine H1 Antagonists, Non-Sedating
• Leukotriene Antagonists
• Quinolines
• Sulfides
• Loratadine
• Terfenadine
• fexofenadine
• desloratadine
• montelukast
• Cetirizine

Topics

• Acetates (therapeutic use)
• Adolescent
• Adult
• Cetirizine (therapeutic use)
• Child
• Child, Preschool
• Cyclopropanes
• Drug Therapy, Combination
• Female
• Histamine H1 Antagonists, Non-Sedating (therapeutic use)
• Humans
• Leukotriene Antagonists (therapeutic use)
• Loratadine (analogs & derivatives, therapeutic use)
• Male
• Middle Aged
• Photosensitivity Disorders (drug therapy, etiology)
• Quinolines (therapeutic use)
• Remission Induction
• Remission, Spontaneous
• Severity of Illness Index
• Sulfides
• Sunlight (adverse effects)
• Terfenadine (analogs & derivatives, therapeutic use)
• Ultraviolet Rays (adverse effects)
• Urticaria (drug therapy, etiology)
• Young Adult