■随着新的治疗选择的出现,传统的治疗性血浆置换(TPE)用于涉及血浆中有毒物质的疾病,仍然是顽固性太阳荨麻疹(SU)病例的可行替代方案。我们强调记录重复血浆置换的成功经验的重要性,以提高医生和皮肤科医生对这种有效治疗选择的认识。
■我们报告了一例对H1-抗组胺药的组合没有反应的顽固性SU,免疫抑制剂,奥马珠单抗和静脉注射免疫球蛋白。我们引入了串行TPE,引入了每个课程连续两天的程序。我们详细介绍了该方案,并强调了多种治疗方法观察到的临床和客观益处。此外,我们将其与其他血浆置换方案及其先前报道的太阳荨麻疹的治疗反应进行了比较。
■我们的患者接受了连续TPE,五年来共有42个程序。在最后一次TPE会议之后,光测显示最小荨麻剂量(MUDS)的持续延长,超过了几乎所有紫外线(UV)和可见光范围内的最大测试剂量,除了两个短紫外线B(UVB)波长。MUD在307.5±5nm处从6mj/cm2增加到25,从320±10nm的15mj/cm2到500,在最初的TPE之前。在我们的审查中,我们纳入了5篇文章,涵盖了8例接受TPE的SU患者.其中,5例皮内试验阳性的患者在治疗后立即反应特别好.然而,一名患者在两周内复发,另一名患者在两个月内复发。相比之下,其他三名皮内试验阴性的患者,从治疗中没有明显的益处。在患者中没有报告来自TPE的严重副作用。
■这篇综述强调了系列血浆置换手术治疗难治性SU的疗效,突出了观察到的稳健结果。
UNASSIGNED: Amidst the emergence of new therapeutic options, traditional therapeutic plasmapheresis (TPE) used in diseases involving a toxic substance in the plasma, remains a viable alternative for cases of recalcitrant solar urticaria (SU). We emphasize the importance of documenting successful experience with repeated plasmapheresis to increase awareness amongst physicians and dermatologists regarding this effective treatment option.
UNASSIGNED: We reported a case of recalcitrant SU that had not responded to a combination of H1-antihistamines, immunosuppressants, omalizumab and intravenous immunoglobulin. We introduced serial TPE, which involved two consecutive days of procedures for each course was introduced. We detailed the regimen and highlighted the clinical and objective benefits observed with multiple treatments. Additionally, we compared this to other plasmapheresis regimens and their treatment responses previously reported for solar urticaria.
UNASSIGNED: Our patient underwent serial TPE, totaling 42 procedures over five years. Following the last TPE session, phototesting showed a sustained prolongation of minimal urticating doses (MUDS), which exceeded the maximum tested doses across nearly all ultraviolet (UV) and visible light ranges, with the exception of the two short ultraviolet B (UVB) wavelengths. MUDs increased to 25 from 6 mj/cm2 at 307.5± 5nm, and to 500 from 15 mj/cm2 at 320 ± 10nm, before the initial TPE. In our review, we included five articles covering eight SU patients who received TPE. Of these, the five patients with positive intradermal tests responded particularly well immediately after treatment. However, the condition relapsed within two weeks in one patient and within two months in another. In contrast, the other three patients with negative intradermal tests, showed no significant benefits from the treatment. No serious side effects from TPE were reported amongst the patients.
UNASSIGNED: This review underscores the efficacy of serial plasmapheresis procedures in treating refractory cases of SU, high3lighting the robust results observed.