Treatment of refractory solar urticaria with plasma exchange.

BACKGROUND

Solar urticaria is a photodermatosis that can be very disabling for patients who are highly sensitive to light and can also be very resistant to therapy.

OBJECTIVE

To correlate the results of serial phototesting in a patient with severe and refractory solar urticaria before and after treatment with plasma exchange.

METHODS

Plasma exchange was performed five times over a period of 10 days. Phototesting to ultraviolet A (UVA) irradiation and visible light was performed with fluorescent ultraviolet tubes and an incandescent lamp.

RESULTS

The urticaria that developed after very low light doses during baseline phototesting could not be provoked following plasma exchange. The patient is now almost symptom-free, with only occasional and transient hives more than 21 months after her last plasma exchange.

CONCLUSIONS

Plasma exchange is a therapeutic modality to consider in highly light-sensitive patients when other treatments have failed.