Successful serial plasmapheresis for solar urticaria, a case report and literature review
Background/Purpose Amidst the emergence of new therapeutic options, traditional therapeutic plasmapheresis (TPE) used in diseases involving a toxic substance in the plasma, remains a viable alternative for cases of recalcitrant solar urticaria (SU). We emphasize the importance of documenting success...
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| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Dermatological Treatment |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/09546634.2024.2350229 |
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| author | Einapak Boontaveeyuwat Fenella Willis Hiva Fassihi Robert P. E. Sarkany |
| author_facet | Einapak Boontaveeyuwat Fenella Willis Hiva Fassihi Robert P. E. Sarkany |
| author_sort | Einapak Boontaveeyuwat |
| collection | DOAJ |
| description | Background/Purpose Amidst the emergence of new therapeutic options, traditional therapeutic plasmapheresis (TPE) used in diseases involving a toxic substance in the plasma, remains a viable alternative for cases of recalcitrant solar urticaria (SU). We emphasize the importance of documenting successful experience with repeated plasmapheresis to increase awareness amongst physicians and dermatologists regarding this effective treatment option.Material and Method We reported a case of recalcitrant SU that had not responded to a combination of H1-antihistamines, immunosuppressants, omalizumab and intravenous immunoglobulin. We introduced serial TPE, which involved two consecutive days of procedures for each course was introduced. We detailed the regimen and highlighted the clinical and objective benefits observed with multiple treatments. Additionally, we compared this to other plasmapheresis regimens and their treatment responses previously reported for solar urticaria.Results Our patient underwent serial TPE, totaling 42 procedures over five years. Following the last TPE session, phototesting showed a sustained prolongation of minimal urticating doses (MUDS), which exceeded the maximum tested doses across nearly all ultraviolet (UV) and visible light ranges, with the exception of the two short ultraviolet B (UVB) wavelengths. MUDs increased to 25 from 6 mj/cm2 at 307.5± 5nm, and to 500 from 15 mj/cm2 at 320 ± 10nm, before the initial TPE. In our review, we included five articles covering eight SU patients who received TPE. Of these, the five patients with positive intradermal tests responded particularly well immediately after treatment. However, the condition relapsed within two weeks in one patient and within two months in another. In contrast, the other three patients with negative intradermal tests, showed no significant benefits from the treatment. No serious side effects from TPE were reported amongst the patients.Conclusions This review underscores the efficacy of serial plasmapheresis procedures in treating refractory cases of SU, highlighting the robust results observed. |
| format | Article |
| id | doaj-art-2909637cc64a4adcbb7809479ddd6122 |
| institution | OA Journals |
| issn | 0954-6634 1471-1753 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj-art-2909637cc64a4adcbb7809479ddd61222025-08-20T01:58:20ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532024-12-0135110.1080/09546634.2024.2350229Successful serial plasmapheresis for solar urticaria, a case report and literature reviewEinapak Boontaveeyuwat0Fenella Willis1Hiva Fassihi2Robert P. E. Sarkany3Photodermatology Unit, St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, London, UKHaematology Department, St. George’s University Hospitals NHS Foundation Trust, London, UKPhotodermatology Unit, St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, London, UKPhotodermatology Unit, St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, London, UKBackground/Purpose Amidst the emergence of new therapeutic options, traditional therapeutic plasmapheresis (TPE) used in diseases involving a toxic substance in the plasma, remains a viable alternative for cases of recalcitrant solar urticaria (SU). We emphasize the importance of documenting successful experience with repeated plasmapheresis to increase awareness amongst physicians and dermatologists regarding this effective treatment option.Material and Method We reported a case of recalcitrant SU that had not responded to a combination of H1-antihistamines, immunosuppressants, omalizumab and intravenous immunoglobulin. We introduced serial TPE, which involved two consecutive days of procedures for each course was introduced. We detailed the regimen and highlighted the clinical and objective benefits observed with multiple treatments. Additionally, we compared this to other plasmapheresis regimens and their treatment responses previously reported for solar urticaria.Results Our patient underwent serial TPE, totaling 42 procedures over five years. Following the last TPE session, phototesting showed a sustained prolongation of minimal urticating doses (MUDS), which exceeded the maximum tested doses across nearly all ultraviolet (UV) and visible light ranges, with the exception of the two short ultraviolet B (UVB) wavelengths. MUDs increased to 25 from 6 mj/cm2 at 307.5± 5nm, and to 500 from 15 mj/cm2 at 320 ± 10nm, before the initial TPE. In our review, we included five articles covering eight SU patients who received TPE. Of these, the five patients with positive intradermal tests responded particularly well immediately after treatment. However, the condition relapsed within two weeks in one patient and within two months in another. In contrast, the other three patients with negative intradermal tests, showed no significant benefits from the treatment. No serious side effects from TPE were reported amongst the patients.Conclusions This review underscores the efficacy of serial plasmapheresis procedures in treating refractory cases of SU, highlighting the robust results observed.https://www.tandfonline.com/doi/10.1080/09546634.2024.2350229Solar urticariaplasmapheresisphotodermatosis |
| spellingShingle | Einapak Boontaveeyuwat Fenella Willis Hiva Fassihi Robert P. E. Sarkany Successful serial plasmapheresis for solar urticaria, a case report and literature review Journal of Dermatological Treatment Solar urticaria plasmapheresis photodermatosis |
| title | Successful serial plasmapheresis for solar urticaria, a case report and literature review |
| title_full | Successful serial plasmapheresis for solar urticaria, a case report and literature review |
| title_fullStr | Successful serial plasmapheresis for solar urticaria, a case report and literature review |
| title_full_unstemmed | Successful serial plasmapheresis for solar urticaria, a case report and literature review |
| title_short | Successful serial plasmapheresis for solar urticaria, a case report and literature review |
| title_sort | successful serial plasmapheresis for solar urticaria a case report and literature review |
| topic | Solar urticaria plasmapheresis photodermatosis |
| url | https://www.tandfonline.com/doi/10.1080/09546634.2024.2350229 |
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