Phototherapy for Treating Chronic Spontaneous Urticaria
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Background: Chronic spontaneous urticaria (CSU) is a disease characterized by the onset of wheals, angioedema and/or both for more than 6 weeks. The clinical characteristics of CSU include wheals and flares that are erythematous or skin- colored. The most frequently used medical therapy is second-generation H1 antihistamines followed by first-generation H1 antihistamines. CSU is currently treated with phototherapy utilizing narrowband ultraviolet B (NB-UVB). Case: A 36-year-old woman presented to the Dermatology and Venereology Outpatient Clinic of DR. Moewardi Hospital, Surakarta, with itchy reddish bumps all over her body since 6 months ago. A dermatology examination obtained multiple erythematous-based urticaria varying in size on her anterior and posterior trunks. We treated this patient with a combination of antihistamines and NB-UVB phototherapy at 200 mJ/cm2 weekly for a month. Significant clinical improvement was observed at week 4 of therapy. Discussion: In the treatment of chronic spontaneous urticaria, NB-UVB phototherapy serves as an adjuvant therapy. It acts as a suppressor of the systemic immune response which reduces the release of histamines and pro-inflammatory mediators, prevents mast cell apoptosis in the dermis, and regulates Th1 as well as Th2. The dose may start at 200 mJ/cm2 then increase by 10-20% for each visit. Conclusion: The combination of antihistamines and NB-UVB has a significant effect on treating chronic spontaneous urticaria.
Zuberbier T, Aberer W, Asero R, Abdul-Latiff AH, Baker D, Ballmer-Weber B. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy.
;73(7):1393-414.
Webster L, Rider N L, Archambault ME. Evaluating and managing chronic idiopathic urticaria in adults. J Am Acad Phys. 2018;31(7);22-6.
Lee SJ, Ha EK, Jee HM, Lee KS, Lee SW, Kim MA, et al. Prevalence and risk factors of urticaria with a focus on chronic urticaria in children. Allergy Asthma Immunol Res. 2017;9(3):212-9.
Lee N, Lee JD, Lee HY, Kang DR, Yel YM.
Epidemiology of chronic urticaria in korea using the korean health insurance database 2010-2014. Allergy Asthma Immunol Res. 2017;9(5):438-45.
Wirantari N, Rosita C, Prakoeswa S. Urtikaria dan angioedema: studi retrospektif. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2010;22(1): 213-9.
Vestergaard C, Deleuran M. Chronic spontaneous urticaria: Latest developments in aetiology, diagnosis and therapy. Ther Adv Chronic Dis. 2015;6(6):304-13.
Magerl M, Altrichter S, Borzova E, Giménez- Arnau A, Grattan CEH, Lawlor F, et al. The definition, diagnostic testing, and management of chronic inducible urticarias - The EAACI/GA2LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy Eur J Allergy Clin Immunol.
;71(6):780-802.
Kanani A, Betschel SD, Warrington R. Urticaria and angioedema. Allergy Asthma Clin Immunol. 2018; 14(2): 59-60.
Stepaniuk P, Kan M, Kanani A. Natural history, prognostic factors and patient perceived response to treatment in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2020;16(1):60-3.
Kaplan AP. Chronic Spontaneous Urticaria: Pathogenesis and Treatment Consideration Allergy Asthma Immunol Res.2017;9(6):477-82.
Sheikh G, Latif I, Sideeq K, Hassan I, Jabeen Y, Keen A. Role of adjuvant narrow band ultraviolet B phototherapy in the treatment of chronic urticaria. Indian J. Dermatol. 2019; 64(3): 1-5.
Fricke J, Avila G, Keller T, Weller K, Lau S, Maurer M, et al. Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis. Allergy. 2020;75(2): 423-32.
Rafikasari A, F Deasy, Setyaningrum T. Profil pasien urtikaria (profile of urticaria patients). Berkala Ilmu Kesehatan Kulit dan Kelamin.2019;31(3):222-7.
Fitria. Aspek Etiologi dan Klinis pada Urtikaria dan Angioedema. J Kedokt Syiah Kuala. 2013;13(2):96-104.
Grattan CEH, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol. 2002; 46(5): 64557.
Mandel VD, Alicandro T, Pepe P, Bonzano L. Chronic spontaneous urticaria: A review of pathological mechanisms, diagnosis, clinical management and treatment. EMJ. 2020;
(1):2939.
Vestergaard C, Deleuran M. Chronic spontaneous urticaria: Latest developments in aetiology, diagnosis and therapy. Ther Adv Chronic Dis. 2015; 6(6): 304-13.
Grattan CEH, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol. 2002; 46(5): 64557.
Kolkhir P, Church MK, Weller K, Metz M, Schmetzer O, Maurer M. Autoimmune chronic spontaneous urticaria: What we know and what
we do not know. J Allergy Clin Immunol. 2017;139(6):1772-81.
Baig SA, Balachandran C, Nayak S. Comparative evaluation of autologous serum skin test and autologous plasma skin test in chronic urticaria. Journal of Pakistan Association of Dermatologists. 2013;23(4):378–83.
Amar SM, Dreskin SC. Urticaria. Prim Care Clin Office Pract. 2008; 35: 141-57
Godse KV. Autologous serum skin test in chronic idiopathic urticaria. Indian J Dermatol Venereol Leprol 2004; 70: 283-4.
Sanchez-Borges M, Asero R, Ansotegui IJ, Baiardini I, Bernstein JA, Canonica GW, et al. WAO Scientific and Clinical Issues Council: Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Oragnization Journal. 2012,5:125-47
Maurer M, Rosen K, Hsieh H-J, Saini S, Grattan C, Gimenez-Arnau A, Agarwal S, Doyle R, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013;368:924-35.
Metz M, Ohanyan T, Church MK, Maurer M: Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: a retrospective clinical analysis. J Dermato Sci. 2013;73(9):57-62.
Sheikh G, Latif I, Lone KS, Hassan I, Jabeen Y, Keen A. Role of Adjuvant Narrow Band
Ultraviolet B Phototherapy in the Treatment of Chronic Urticaria. Indian J Dermatol. 2019 May- Jun;64(3):250.
Chen J, Zeng X, Chen Q, Liang B, Pen L, Li H, et al. Efficacy of NB-UVB as on therapy to antihistamine in the treatment of chronic urticaria: a systematic review and meta-analysis. J. Derm and Therapy. 2021;11(1):681-94.
Yeon H, Hwa M, Lee H, Sung H, Juan S, Young K. Phototherapy May be a Useful Adjuvant Therapy for Retractable Chronic Spontaneous Urticaria: A Systematic Review. J Photochemestry and photobiology. 2019;10(3):1-3.
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