Phototherapy May be a Useful Adjuvant Therapy for Retractable Chronic Spontaneous Urticaria: A Systematic Review

The recent guideline on the management of urticaria recommends second‐generation H1 antihistamine as the first‐line therapy, with dose increases of up to fourfold and the addition of omalizumab or cyclosporine if inadequately controlled. However, the treatment of chronic spontaneous urticaria (CSU)...

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Bibliographic Details
Published in:Photochemistry and photobiology 2020-07, Vol.96 (4), p.738-740
Main Authors: Hong, Ji Yeon, Kim, Myung Hwa, Lee, Ji Hyun, Han, Hye Sung, Seo, Seong Jun, Park, Kui Young, Park, Young Min
Format: Article
Language:English
Subjects:
Adjuvant therapy
Antihistamines
Chronic Disease
Combined Modality Therapy
Cyclosporins
Histamine
Histamine H1 Antagonists - therapeutic use
Humans
Immunoglobulin E
Light therapy
Monoclonal antibodies
Phototherapy
Systematic review
Urticaria
Urticaria - drug therapy
Urticaria - therapy
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Summary:The recent guideline on the management of urticaria recommends second‐generation H1 antihistamine as the first‐line therapy, with dose increases of up to fourfold and the addition of omalizumab or cyclosporine if inadequately controlled. However, the treatment of chronic spontaneous urticaria (CSU) is often disappointing. Therefore, a safe and effective treatment option is needed for refractory CSU. To evaluate whether phototherapy can relieve urticarial symptoms and serve as an additional treatment for CSU uncontrolled with antihistamine, we performed a qualitative systematic review. Our result suggests that NBUVB could be an effective complementary treatment modality to manage refractory CSU. Chronic spontaneous urticaria (CSU) is highly prevalent and often refractory to the conventional treatment options. In this systematic review, it was observed that NBUVB could be an effective complementary treatment modality to manage refractory CSU. The efficacy of NBUVB to relieve urticarial symptoms may be explained by two mechanisms. First, NBUVB is proposed to induce apoptosis of dermal mast cells and decrease the production of proinflammatory cytokines released by mast cell degranulation. Second, UVB may primarily affect the T cells in lesional skin, which probably plays a key role in the pathogenesis of urticaria.
ISSN:0031-8655
1751-1097
DOI:10.1111/php.13260