Stepwise treatment is the best way to manage solar urticaria, a rare but disabling photodermatosis mediated by immunoglobulin E (IgE), according to a systematic review and meta-analysis in the Journal of Clinical Medicine .

A group led by Maya Engler Markowitz, MD, a dermatologist at Rabin Medical Center in Petah Tikva, Israel, concluded that therapy should begin with high-dose H1 antihistamines, with the addition of leukotriene receptor antagonists if necessary. If these are ineffective, the next steps are phototherapy and immunotherapy with a biologic.

Though its exact prevalence is unknown — a recent study found its occurrence to be rising in the US, particularly in children. Solar urticaria can significantly impair quality of life and severely limit daily activities. It is esti

See Full Page