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    Erythropoietic protoporphyria and solar urticaria.
    Br J Dermatol 2018 Apr 23. Epub 2018 Apr 23.
    Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, U.K.
    Tewari et al report three patients with erythropoietic protoporphyria (EPP) who also had symptoms of a solar urticarial-like reaction. Phototesting showed an abnormal response to ultraviolet A and visible light occurring within minutes of irradiation, and resolving in up to 30 min. The authors suggest that these patients have coexisting EPP and solar urticaria, both rare diseases, but comment on the lack of knowledge of phototest responses in EPP. Read More

    Omalizumab for the Treatment of Solar Urticaria: Case Series and Systematic Review of the Literature.
    J Allergy Clin Immunol Pract 2018 Mar 20. Epub 2018 Mar 20.
    Photodermatosis Clinic, Department of Dermatology, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:
    Background: Solar urticaria (SU) is a rare photodermatosis causing a significant impact on patients' quality of life. Although the condition can be controlled with phototherapy and/or a combination therapy of antihistamines and leukotriene antagonist in most patients, a subset of patients require additional therapy with omalizumab; however, efficacy data are sparse.

    Objective: The objective of this study was to determine the efficacy and safety of omalizumab for treating SU. Read More

    Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children.
    Photodermatol Photoimmunol Photomed 2018 Mar 13. Epub 2018 Mar 13.
    Centre for Dermatology Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
    Background: Solar urticaria (SU) is a rare chronic inducible urticaria triggered via uncharacterized chromophores. We detail responses of a large patient series to monochromator phototesting and broadband ultraviolet radiation (UVR); relationship to life quality is explored.

    Methods: Retrospective review of all SU patients undergoing standardized diagnostic photoinvestigation at a specialist centre during 2000-2016. Read More

    Clinical and photobiological response in eight patients with solar urticaria under treatment with omalizumab, and review of the literature.
    Photodermatol Photoimmunol Photomed 2017 Nov 24. Epub 2017 Nov 24.
    Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
    Background: Solar urticaria (SU) is a rare photodermatosis. Treatment is challenging, and outcomes are often disappointing. Omalizumab is an anti-IgE, currently approved for treatment of chronic spontaneous urticaria. Read More

    [Solar urticaria. Case report and literature review].
    Rev Alerg Mex 2017 Jul-Sep;64(3):371-375
    Universidad de Antioquia, IPS Universitaria, Grupo de Alergología Clínica y Experimental, Medellín, Colombia.
    Background: Solar urticaria is a rare type of inducible urticaria characterized by wheal and erythema formation shortly after exposure to sunlight or to an artificial light source; its pathophysiology is not yet entirely understood. The treatment of choice, in addition to exposure avoidance, consists in antihistamine administration.

    Clinical Case: This is the case of a 27-year-old woman with no personal history of allergic diseases and with a 2-year history of erythema and wheals in photo-exposed areas associated with sunlight exposure for periods longer than 10 minutes. Read More

    Omalizumab treatment in patients with chronic inducible urticaria: A systematic review of published evidence.
    J Allergy Clin Immunol 2018 Feb 24;141(2):638-649. Epub 2017 Jul 24.
    Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
    Background: Omalizumab, a recombinant anti-IgE antibody, effectively treats chronic spontaneous urticaria. Evidence is lacking in patients with chronic inducible urticarias (CIndUs), which are frequently H-antihistamine resistant.

    Objective: From the current published literature, we aimed to determine the strength of evidence for omalizumab efficacy and safety in the treatment of CIndUs. Read More

    Long-term management of chronic spontaneous urticaria with omalizumab.
    Clin Exp Dermatol 2017 Oct 25;42(7):735-742. Epub 2017 Jun 25.
    Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.
    Background: Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking.

    Aim: To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens.

    Methods: This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines. Read More

    Response to Omalizumab in Solar Urticaria: Report of 3 Cases.
    Actas Dermosifiliogr 2017 Oct 27;108(8):e53-e55. Epub 2017 Apr 27.
    Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
    We report 3 cases of solar urticaria in which there was no response or limited response to first-line treatments with high-dose H antihistamines or phototherapy. The patients were then treated with omalizumab. Symptoms improved in 2 patients, whose tolerance to sunlight increased considerably; quality of life clearly improved for 1 of these patients. Read More

    Pharmacokinetics and Pharmacodynamics of Afamelanotide and its Clinical Use in Treating Dermatologic Disorders.
    Clin Pharmacokinet 2017 Aug;56(8):815-823
    Stadtspital Triemli, Institute of Laboratory Medicine, Zurich, Switzerland.
    Afamelanotide, the first α-melanocyte-stimulating hormone (MSH) analogue, synthesized in 1980, was broadly investigated in all aspects of pigmentation because its activity and stability were higher than the natural hormone. Afamelanotide binds to the melanocortin-1 receptor (MC1R), and MC1R signaling increases melanin synthesis, induces antioxidant activities, enhances DNA repair processes and modulates inflammation. The loss-of-function variants of the MC1R present in fair-skinned Caucasians are less effectively activated by the natural hormone. Read More

    [Partial response of solar urticaria to omalizumab therapy].
    Hautarzt 2017 Jun;68(6):492-496
    Klinik für Hautkrankheiten und Allergologie, HELIOS Vogtland-Klinikum Plauen GmbH, 100153, 08505, Plauen, Deutschland.
    The treatment of solar urticaria is regarded as difficult. In some cases good responses to the anti-IgE antibody omalizumab (Xolair®), approved for treatment of chronic spontaneous urticaria, have been reported. We report on a 50-year-old Caucasian woman who for the last 5 years has developed localized itching and stinging erythemas following exposure to sunlight accompanied sometimes by anaphylactic reactions. Read More

    Clinical and etiologic evaluation of the children with chronic urticaria.
    Allergy Asthma Proc 2016 Nov;37(6):450-457
    Pediatric Allergy and Immunology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.
    Background: Chronic urticaria (CU) is a skin disorder defined as daily or almost daily exhibition of pruritic and transient wheals that last for 6 weeks. CU is divided into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU).

    Objectives: To evaluate the clinical features, possible causes, associated findings, and laboratory results of different subtypes of CU in children according to a new classification. Read More

    Solar urticaria: Epidemiology and clinical phenotypes in a Spanish series of 224 patients.
    Actas Dermosifiliogr 2017 Mar 25;108(2):132-139. Epub 2016 Oct 25.
    Unidad de Fotobiología Dermatológica y Oncología Cutánea, Departamento de Dermatología y Medicina, Universidad de Málaga, Málaga, España.
    Background: Solar urticaria is a chronic inducible urticaria also classified as an idiopathic dermatosis. The objective of this paper is to define the phenotypic characteristics of solar urticaria and to evaluate its incidence.

    Material And Method: This was a retrospective multicenter study in which data were gathered on the epidemiology and clinical, photobiologic, laboratory, and therapeutic characteristics of solar urticaria. Read More

    Solar urticaria induced by visible light: successful treatment with omalizumab.
    Clin Exp Dermatol 2016 Dec 20;41(8):890-892. Epub 2016 Oct 20.
    Department of Dermatology and Allergy Unit, University Hospital, Basel, Switzerland.
    We report the case of a 53-year-old man with solar urticaria (SU) not responding to histamine antagonist therapy. Using intradermal testing with the patient's irradiated serum, we demonstrated that his SU was elicited by visible light only. This type of SU is uncommon, and makes preventive measures such as sun block largely ineffective. Read More

    Omalizumab in the Treatment of Chronic Inducible Urticaria.
    Actas Dermosifiliogr 2017 Jun 5;108(5):423-431. Epub 2016 Oct 5.
    Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
    Omalizumab is a recombinant humanized monoclonal antibody that inhibits immunoglobulin E. It has been approved for the treatment of severe asthma and chronic spontaneous urticaria refractory to other treatments. Its use in the management of chronic inducible urticaria (a type triggered by certain stimuli) is still considered off-label, although this use has been discussed in some consensus papers. Read More

    Infrared radiation increases skin damage induced by other wavelengths in solar urticaria.
    Photodermatol Photoimmunol Photomed 2016 Sep;32(5-6):284-290
    Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain.
    Background: Photodermatoses are typically investigated by analyzing the individual or combined effects of ultraviolet A (UVA), ultraviolet B (UVB), and visible light using light sources that simulate portions of the solar spectrum. Infrared radiation (IRR), however, accounts for 53% of incident solar radiation, but its effects are not taken into account in standard phototest protocols.

    Aims: The aim was to analyze the effects of IRR, alone and combined with UVA and visible light on solar urticaria lesions, with a distinction between infrared A (IRA) and infrared B (IRB). Read More

    Wedelolactone mitigates UVB induced oxidative stress, inflammation and early tumor promotion events in murine skin: plausible role of NFkB pathway.
    Eur J Pharmacol 2016 Sep 6;786:253-264. Epub 2016 May 6.
    Section of Molecular Carcinogenesis and Chemoprevention Toxicology, Department of Medical Elementology and Toxicology, Faculty of Science, Jamia Hamdard (Hamdard University), Hamdard Nagar, New Delhi 110062, India. Electronic address:
    UVB (Ultra-violet B) radiation is one of the major etiological factors in various dermal pathology viz. dermatitis, actinic folliculitis, solar urticaria, psoriasis and cancer among many others. UVB causes toxic manifestation in tissues by inciting inflammatory and tumor promoting events. Read More

    Analysis of solar urticaria in Thai patients.
    Asian Pac J Allergy Immunol 2016 Jun;34(2):146-52
    Department of Dermatology Faculty of Medicine Siriraj Hospital, Mahidol University 2 Wanglang Road, Bangkoknoi, Bangkok, THAILAND 10700.
    Background: Solar urticaria (SU) is an uncommon photodermatosis characterized by erythema and whealing within minutes to a few hours after exposure to sunlight or an artificial light source.

    Objective: To determine the clinical features, photobiological characteristics and treatment outcomes in Thai SU patients visiting a tertiary referral hospital.

    Method: A retrospective analysis of 13 patients with SU was conducted. Read More

    Heat urticaria: a revision of published cases with an update on classification and management.
    Br J Dermatol 2016 Sep 30;175(3):473-8. Epub 2016 Jun 30.
    Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy.
    Heat urticaria (HU) is a rare type of physical inducible urticaria, characterized by itchy erythema and well-demarcated weals appearing soon after heat exposure. Most cases occur in female patients aged 20-45 years. Both localized and generalized forms exist, depending on the limitation of the reaction to the skin area directly exposed to the physical stimulus or the involvement of distant sites, respectively. Read More

    Omalizumab in patients with severe and refractory solar urticaria: A phase II multicentric study.
    J Am Acad Dermatol 2016 Mar;74(3):574-5
    Université Paris Diderot, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Service de Dermatologie, Paris, France. Electronic address:

    Solar urticaria.
    J Dtsch Dermatol Ges 2015 Dec;13(12):1250-3
    Department of Dermatology, University Medical Center Jena, Jena, Germany.
    Solar urticaria is a rare IgE-mediated and chromophore-dependent photodermatosis. In some cases, these chromophores, designated as "serum factor", may be detected in serum or plasma. To date, the exact pathogenesis of solar urticaria has, however, not been elucidated. Read More

    Doxycycline-Induced Solar Urticaria: A Report of Two Cases.
    J Drugs Dermatol 2015 Nov;14(11):1358-9
    We report two cases of doxycycline-induced solar urticaria that developed shortly after initiation of therapy with persistence despite discontinuation. Consequently, dermatologists should be aware of the association between doxycycline and solar urticaria and counsel their patients on the potential for this side effect when prescribing doxycycline. Read More

    Treatment of solar urticaria using antihistamine and leukotriene receptor antagonist combinations tailored to disease severity.
    Photodermatol Photoimmunol Photomed 2015 Nov 26;31(6):302-6. Epub 2015 Jun 26.
    Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
    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. Read More

    Effect of tetracycline and UV radiation on melanization and antioxidant status of melanocytes.
    J Photochem Photobiol B 2015 Jul 27;148:168-173. Epub 2015 Apr 27.
    Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Silesia, Jagiellońska 4, PL 41-200 Sosnowiec, Poland.
    Tetracycline is a semisynthetic antibiotic and is used in several types of infections against both gram-positive and gram-negative bacteria. This therapy is often associated with phototoxic reactions that occur after exposure to UV radiation and lead to photo-onycholysis, pseudoporphyria, solar urticaria and the fixed drug eruption in the skin. The phototoxic reactions may be related to the melanin content which, on one side may bind drugs - leading to their accumulation, and on the other side, they have photoprotective and antioxidant properties. Read More

    [Angioedema and urticaria].
    Ann Dermatol Venereol 2014 Nov;141 Suppl 3:S586-95
    Centre national de référence des angioedèmes (CREAK), CHU de Grenoble, Hôpital Nord, Boulevard de la Chantourne, 38700 La Tronche, France; Clinique universitaire de médecine interne, Pôle pluridisciplinaire de médecine, CHU de Grenoble - Hôpital Albert Michallon, BP 217, Boulevard de la Chantourne, 38043 Grenoble cedex 9, France.
    Angiœdema (AE) is the clinical expression of urticaria (U) which occurs when urticaria is located within the subcutis. It is a syndrome characterized by a sudden and limited subcutaneous and/or submucous swelling. The updated classification of urticaria distinguishes acute and chronic urticaria. Read More

    Dissociation between history and challenge in patients with physical urticaria.
    J Allergy Clin Immunol Pract 2014 Nov-Dec;2(6):786-90. Epub 2014 Sep 8.
    Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
    Background: Physical urticaria is a subtype of chronic urticaria induced by a physical stimulus.

    Objective: To evaluate the consistency between a history of physical urticaria and results of challenge testing.

    Methods: Seventy-six subjects, ages 3 to 77 years old, were referred with the diagnosis of a physical urticaria and were evaluated by using challenge testing directed toward the presenting diagnosis, yet included other stimuli based on history. Read More

    Severe and refractory solar urticaria treated with intravenous immunoglobulins: a phase II multicenter study.
    J Am Acad Dermatol 2014 Nov 16;71(5):948-953.e1. Epub 2014 Aug 16.
    Université Paris Diderot, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Service de Dermatologie, Paris, France. Electronic address:
    Background: Retrospective data have suggested the effectiveness of intravenous immunoglobulins (IVIG) for solar urticaria (SU).

    Objective: We sought to prospectively assess the efficacy of IVIG for SU.

    Methods: We conducted a multicentric phase II study to test the efficacy of a single course of IVIG (2 g/kg) in patients with severe and refractory SU. Read More

    Minireview: Peptide analogs and short sequence oligopeptides as modulators of skin pigmentation.
    Curr Top Med Chem 2014 ;14(12):1418-24
    Escape Therapeutics, Inc., 5941 Optical Court, San Jose, CA 95138, USA.
    Short sequence amino acids or oligopeptides have recently garnered attention for use as treatments for a myriad of dermatologic disorders due to their ability to effect and modulate various biological processes in the epidermis and dermis, rendering them promising candidates as medical and cosmeceutical therapeutics. Major advantages include their relative ease of synthesis and multitude of modifications that can be applied to enhance potency, affinity, specificity, hydrophilicity or hydrophobicity and cytotoxicity. Given the photoprotective effects of eumelanin on skin, there has been substantial interest in developing agents, particularly α-MSH analogs, that can induce 'sunless tanning' helping reduce risk of melanoma and non-melanoma skin cancer. Read More

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