ABSTRACT
BACKGROUND: Idiopathic solar urticaria (SU) is a rare type of physical urticaria, occurring immediately after exposure to visible or ultraviolet (UV) light. Treatment is based on sun avoidance and on high doses of antihistamines, but is sometimes inefficient. METHODS: We report on a 41-year-old patient with severe SU who was successfully treated with a single course of 2 g/kg of intravenous immunoglobulins (IVIG). RESULTS: A dramatic improvement in UVA and UVB tolerance was rapidly observed, with an increase of up to 10 times the UVA minimal urticarial dose on day 3. The treatment with terfenadine was continued. Healing of photosensitivity was persistent since 100 days after the single course of IVIG, no urticarian reaction was provoked with polychromatic irradiation rising above 8.3 J/cm(2) or after UVA doses rising above 15 J/cm(2). CONCLUSION: Use of IVIG in severe SU can be discussed when high-dose antihistamines are inefficient and quality of life is affected.
Subject(s)
Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Photosensitivity Disorders/drug therapy , Sunlight/adverse effects , Urticaria/drug therapy , Adult , Histamine H1 Antagonists, Non-Sedating/therapeutic use , Humans , Male , Terfenadine/therapeutic use , Urticaria/etiologySubject(s)
Erythema/chemically induced , Foot Dermatoses/chemically induced , Gastrointestinal Stromal Tumors/drug therapy , Hand Dermatoses/chemically induced , Piperazines/adverse effects , Protein Kinase Inhibitors/adverse effects , Pyrimidines/adverse effects , Benzamides , Biopsy, Needle , Drug Eruptions/etiology , Follow-Up Studies , Foot Dermatoses/pathology , Gastrointestinal Stromal Tumors/pathology , Hand Dermatoses/pathology , Humans , Imatinib Mesylate , Immunohistochemistry , Liver Neoplasms/secondary , Male , Middle Aged , Neoplasm Staging , Piperazines/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Pyloric Antrum , Pyrimidines/therapeutic use , Risk Assessment , Stomach Neoplasms/secondary , SyndromeABSTRACT
We describe an atypical primary HSV 1 genital infection with bilateral palmar involvement. Two routes of dissemination of HSV are discussed, self-inoculation and blood dissemination. This case highlights the role of HSV 1 in extragenital pustules in the context of sexually transmitted diseases.
