Solar urticaria, a disease with many dark sides: is omalizumab the right therapeutic response? Reflections from a clinical case report

Solar urticaria is a rare type of photodermatosis that significantly reduces the quality of life of the subjects affected, with a risk of anaphylaxis should the entire body be exposed to the sun. Patients are forced to modify and limit their normal activities, and since the symptoms are triggered by exposure to sun, which is difficult if not impossible to avoid in everyday life, a safe and effective therapy appears to be essential. Unfortunately, traditional therapies in a discrete number of patients are unable to provide adequate and safe answers. We describe the case of an 18-year-old woman who began to manifest the first symptoms walking under the spring sunshine. A few minutes after sun exposure, itching and burning sensation began, followed immediately by erythema appearance in the photoexposed skin areas. She was treated with non-sedating H1-blocking antihistamines and leukotriene antagonist with no success, so we decided to treat with omalizumab. The satisfactory response after the failure of previous standard therapeutic strategies, confirms the effectiveness of this molecule in the treatment of solar urticaria, which despite what reported in several studies, has not yet been recognized and authorized by the competent Health Authorities in the treatment of this condition.