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Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children

Summary 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 Retrospec...

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Published in:Photodermatology, photoimmunology & photomedicine photoimmunology & photomedicine, 2018-07, Vol.34 (4), p.262-268
Main Authors: Haylett, Ann K., Koumaki, Dimitra, Rhodes, Lesley E.
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description Summary 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. From 2011, patients completed dermatology life quality index (DLQI) questionnaires for the past week and year. Results In 145 patients (mean: 35.8, range: 3‐69 years; 18 aged
doi_str_mv 10.1111/phpp.12385
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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. From 2011, patients completed dermatology life quality index (DLQI) questionnaires for the past week and year. Results In 145 patients (mean: 35.8, range: 3‐69 years; 18 aged &lt;18 years; 100 female), combined phototesting with broadband UVR and monochromator sources successfully provoked 74.5% patients, with 65.6% provoked by broadband UVR alone and 57.9% by monochromated radiation alone. The narrow wavebands most frequently eliciting wheal and flare response were between 370 and 400 nm, with 25% patients at 300 ± 5 nm, 53.6% at 320 ± 10 nm, 66.7% at 330 ± 10 nm, 77.4% at 350 ± 20 nm, 83.3% at 370 ± 20 nm, 86.9% at 400 ± 20 nm, 44% at 500 ± 20 nm and 17.8% at 600 ± 20 nm. In 62 patients, the DLQI revealed 56.1% had very to extremely large impact in the past week (all patients: mean score: 11.1, range: 0‐29) rising to 69.8% for the past year (12.5, 0‐30); adults and children were similarly affected. Patients with positive photoprovocation had higher DLQI score than those who were negative (DLQI for past week: mean: 12.6 ± SEM 1.1 vs 4.6 ± 1.4, P &lt; .01). Conclusion SU is predominantly provoked by longer UVA‐shorter visible radiation, which penetrates window‐glass and where sunscreens are less effective; impact on life quality is considerable. Photoprotective agents effective against this spectrum are needed.</description><identifier>ISSN: 0905-4383</identifier><identifier>EISSN: 1600-0781</identifier><identifier>DOI: 10.1111/phpp.12385</identifier><identifier>PMID: 29533487</identifier><language>eng</language><publisher>England</publisher><subject>action spectra ; photosensitivity ; quality of life ; solar urticaria ; ultraviolet radiation ; visible light</subject><ispartof>Photodermatology, photoimmunology &amp; photomedicine, 2018-07, Vol.34 (4), p.262-268</ispartof><rights>2018 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd</rights><rights>2018 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4315-a1c75be7f6255e0f668387cc539d22c9d8caeee413ff68bb84989a484fbfb89a3</citedby><cites>FETCH-LOGICAL-c4315-a1c75be7f6255e0f668387cc539d22c9d8caeee413ff68bb84989a484fbfb89a3</cites><orcidid>0000-0002-9107-6654</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29533487$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haylett, Ann K.</creatorcontrib><creatorcontrib>Koumaki, Dimitra</creatorcontrib><creatorcontrib>Rhodes, Lesley E.</creatorcontrib><title>Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children</title><title>Photodermatology, photoimmunology &amp; photomedicine</title><addtitle>Photodermatol Photoimmunol Photomed</addtitle><description>Summary 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. From 2011, patients completed dermatology life quality index (DLQI) questionnaires for the past week and year. Results In 145 patients (mean: 35.8, range: 3‐69 years; 18 aged &lt;18 years; 100 female), combined phototesting with broadband UVR and monochromator sources successfully provoked 74.5% patients, with 65.6% provoked by broadband UVR alone and 57.9% by monochromated radiation alone. The narrow wavebands most frequently eliciting wheal and flare response were between 370 and 400 nm, with 25% patients at 300 ± 5 nm, 53.6% at 320 ± 10 nm, 66.7% at 330 ± 10 nm, 77.4% at 350 ± 20 nm, 83.3% at 370 ± 20 nm, 86.9% at 400 ± 20 nm, 44% at 500 ± 20 nm and 17.8% at 600 ± 20 nm. In 62 patients, the DLQI revealed 56.1% had very to extremely large impact in the past week (all patients: mean score: 11.1, range: 0‐29) rising to 69.8% for the past year (12.5, 0‐30); adults and children were similarly affected. Patients with positive photoprovocation had higher DLQI score than those who were negative (DLQI for past week: mean: 12.6 ± SEM 1.1 vs 4.6 ± 1.4, P &lt; .01). Conclusion SU is predominantly provoked by longer UVA‐shorter visible radiation, which penetrates window‐glass and where sunscreens are less effective; impact on life quality is considerable. Photoprotective agents effective against this spectrum are needed.</description><subject>action spectra</subject><subject>photosensitivity</subject><subject>quality of life</subject><subject>solar urticaria</subject><subject>ultraviolet radiation</subject><subject>visible light</subject><issn>0905-4383</issn><issn>1600-0781</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kF1LwzAUhoMobk5v_AGSSxGqSZO0qXdjqBMGDtTrkqYnLJJ-LGmR_XvbbXrpuTnnvDw8Fy9C15Tc02Ee2k3b3tOYSXGCpjQhJCKppKdoSjIiIs4km6CLEL4IIZwTeo4mcSYY4zKdIv_eOOVx7zurlbcK2xpTLnCrOgt1Fx7xPAQIoRoe3BisdGebGocWdOcVVnWJbdUOKR7Sba-c7XYj56yB0aXK3nVhz-mNdaWH-hKdGeUCXB33DH0-P30sltHq7eV1MV9FmjMqIkV1KgpITRILAcQkiWQy1VqwrIxjnZVSKwDglBmTyKKQPJOZ4pKbwhTDxWbo9uBtfbPtIXR5ZYMG51QNTR_ymFAmqEiIHNC7A6p9E4IHk7feVsrvckryseN87DjfdzzAN0dvX1RQ_qG_pQ4APQDf1sHuH1W-Xq7XB-kP92KH5w</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Haylett, Ann K.</creator><creator>Koumaki, Dimitra</creator><creator>Rhodes, Lesley E.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9107-6654</orcidid></search><sort><creationdate>201807</creationdate><title>Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children</title><author>Haylett, Ann K. ; Koumaki, Dimitra ; Rhodes, Lesley E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4315-a1c75be7f6255e0f668387cc539d22c9d8caeee413ff68bb84989a484fbfb89a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>action spectra</topic><topic>photosensitivity</topic><topic>quality of life</topic><topic>solar urticaria</topic><topic>ultraviolet radiation</topic><topic>visible light</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haylett, Ann K.</creatorcontrib><creatorcontrib>Koumaki, Dimitra</creatorcontrib><creatorcontrib>Rhodes, Lesley E.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Photodermatology, photoimmunology &amp; photomedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haylett, Ann K.</au><au>Koumaki, Dimitra</au><au>Rhodes, Lesley E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children</atitle><jtitle>Photodermatology, photoimmunology &amp; photomedicine</jtitle><addtitle>Photodermatol Photoimmunol Photomed</addtitle><date>2018-07</date><risdate>2018</risdate><volume>34</volume><issue>4</issue><spage>262</spage><epage>268</epage><pages>262-268</pages><issn>0905-4383</issn><eissn>1600-0781</eissn><abstract>Summary 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. From 2011, patients completed dermatology life quality index (DLQI) questionnaires for the past week and year. Results In 145 patients (mean: 35.8, range: 3‐69 years; 18 aged &lt;18 years; 100 female), combined phototesting with broadband UVR and monochromator sources successfully provoked 74.5% patients, with 65.6% provoked by broadband UVR alone and 57.9% by monochromated radiation alone. The narrow wavebands most frequently eliciting wheal and flare response were between 370 and 400 nm, with 25% patients at 300 ± 5 nm, 53.6% at 320 ± 10 nm, 66.7% at 330 ± 10 nm, 77.4% at 350 ± 20 nm, 83.3% at 370 ± 20 nm, 86.9% at 400 ± 20 nm, 44% at 500 ± 20 nm and 17.8% at 600 ± 20 nm. In 62 patients, the DLQI revealed 56.1% had very to extremely large impact in the past week (all patients: mean score: 11.1, range: 0‐29) rising to 69.8% for the past year (12.5, 0‐30); adults and children were similarly affected. Patients with positive photoprovocation had higher DLQI score than those who were negative (DLQI for past week: mean: 12.6 ± SEM 1.1 vs 4.6 ± 1.4, P &lt; .01). Conclusion SU is predominantly provoked by longer UVA‐shorter visible radiation, which penetrates window‐glass and where sunscreens are less effective; impact on life quality is considerable. Photoprotective agents effective against this spectrum are needed.</abstract><cop>England</cop><pmid>29533487</pmid><doi>10.1111/phpp.12385</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9107-6654</orcidid><oa>free_for_read</oa></addata></record>
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subjects action spectra
photosensitivity
quality of life
solar urticaria
ultraviolet radiation
visible light
title Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children
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