Solar urticaria: Epidemiology and clinical phenotypes in a Spanish series of 224 patients

Actas Dermosifiliogr. 2017 Mar;108(2):132-139. doi: 10.1016/j.ad.2016.09.003. Epub 2016 Oct 25.
[Article in English, Spanish]

Abstract

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.

Results: A total of 224 patients (141 women and 83 men) were included from 9 photobiology units. The mean age of the patients was 37.9 years (range, 3-73 years). A history of atopy was detected in 26.7%, and the most common presentation was allergic rhinitis (16.5%). Clinical signs were limited to sun-exposed areas in 75.9% of patients. The light spectrum most commonly implicated was visible light only (31.7%), and in 21% of cases it was only possible to trigger solar urticaria with natural light. The treatments most widely used by photobiology experts were oral antihistamines (65.46%), followed by different forms of phototherapy (34%). Complete resolution was observed most often in patients with solar urticaria triggered exclusively by visible or natural light, with statistically significant differences with respect to other wavelengths (P<.05). No increase in the annual incidence of solar urticaria was observed.

Conclusions: We have presented the largest series of solar urticaria published to date. The epidemiological, clinical, and photobiologic findings confirm previously reported data, although there was a particularly high rate of negative phototests in our series. Reactivity exclusively to visible or natural light was associated with a higher probability of resolution. No increasing trend was observed in the annual incidence.

Keywords: Fotodermatosis; Photodermatosis; Physical urticaria; Solar urticaria; Urticaria física; Urticaria solar.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Phenotype
  • Photosensitivity Disorders / epidemiology
  • Photosensitivity Disorders / etiology*
  • Photosensitivity Disorders / pathology
  • Photosensitivity Disorders / therapy
  • Phototherapy
  • Retrospective Studies
  • Spain / epidemiology
  • Sunlight / adverse effects*
  • Urticaria / epidemiology
  • Urticaria / etiology*
  • Urticaria / pathology
  • Urticaria / therapy
  • Young Adult

Substances

  • Histamine Antagonists