Scientific letter
Effectiveness in the treatment of solar urticaria with omalizumab: Report of 7 cases
Efectividad en el tratamiento de la urticaria solar con omalizumab: serie de 7 casos
Antonio Sahuquillo-Torralba, Mercedes Rodríguez-Serna
, Rafael Botella Estrada
Corresponding author
Servicio de Dermatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
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The trigger is solar radiation or artificial light sources generally through the spectrum of visible light, UVA or a combination of both.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Epidemiological, clinical, IgE levels and response to treatment data were collected in all patients diagnosed with SU who required treatment with omalizumab from January 2016 to August 2017 in the Dermatology Service of the University Hospital La Fe of Valencia. Despite the use of second-generation anti-histamines at the maximum doses (4 tablets per day), the patient's quality of life was greatly affected. In all cases, a study was carried out in the photobiology unit using a Phototest at diagnosis, and after reaching clinical response with omalizumab. Complementary tests to rule out other photodermatoses, such as porphyrins in urine, ANA, viral serologies and TSH, were normal in all patients. Complete response (CR) was considered when patients were asymptomatic during their daily activities and prolonged solar exposures, together with a negative Phototest. Partial response (PR) was considered when patients were asymptomatic during their daily activities with improvement or negative Phototest, but with clinical manifestations to prolonged solar exposures.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Seven patients were treated with omalizumab. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the main variables studied. The starting dose was indicated in the SmPC for chronic spontaneous urticaria (CSU). The dose was increased to 300<span class="elsevierStyleHsp" style=""></span>mg/15 days, and if necessary to 450<span class="elsevierStyleHsp" style=""></span>mg/15 days in patients without an adequate response after at least 3 months of treatment. All patients responded to omalizumab, achieving CR in 4 patients (57%) and PR in 3 patients (43%). The necessary doses were 300<span class="elsevierStyleHsp" style=""></span>mg/month in 4 patients (58%) and 450<span class="elsevierStyleHsp" style=""></span>mg/15 days in the remaining 3 (42%), with 2 of these 3 cases having a BMI greater than 30, so it is likely that high BMI patients require higher doses. Phototest was negative in all patients who achieved CR, and in 2 patients with PR. In the remaining patient, an PR was obtained with negative Phototest in the visible light spectrum, and improvement for the UVA spectrum without negative results. Treatment optimization was performed in all patients after obtaining a sustained response of at least 4–6 months at the minimum effective dose. All required a minimum maintenance dose of 300<span class="elsevierStyleHsp" style=""></span>mg/month, allowing the complete withdrawal of anti-histamines in 5 patients. There was a relapse of the disease in 3 patients after optimization at 150<span class="elsevierStyleHsp" style=""></span>mg/month, with total withdrawal in one of them. However, a dose increase or the reintroduction of the treatment achieved disease remission again, without the need to administer doses that were higher than those previously used for the same patient. None of our patients suffered side effects.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">We report the largest series published to date of SU treated with omalizumab. A total of 20 patients with SU treated with omalizumab were found in a literature search, including clinical cases and small series of patients.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–5</span></a> According to the publications found, cases with elevated baseline IgE levels usually show a greater response to treatment, however, in our series, the only 2 patients with high IgE levels required a dose of 450<span class="elsevierStyleHsp" style=""></span>mg/15 days to control the disease.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In our experience, omalizumab has been shown to be an effective and safe drug in antihistamine-resistant SU. The most appropriate starting dose seems to be 300<span class="elsevierStyleHsp" style=""></span>mg/month, with subsequent intensification or optimization. All the cases responded to treatment, allowing normal daily activity with doses that ranged between 300<span class="elsevierStyleHsp" style=""></span>mg/month and 450<span class="elsevierStyleHsp" style=""></span>mg/15 days. High levels of IgE did not correlate with better response to treatment in our patients. Maintenance doses below 300<span class="elsevierStyleHsp" style=""></span>mg/month or discontinuation of the drug have been associated with disease recurrence, however, dose increase, or reintroduction have not shown a loss of clinical response in recurrence control and maintenance. Patients with high BMI may need higher doses, and studies with a larger sample size would be needed in order to confirm this finding.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sahuquillo-Torralba A, Rodríguez-Serna M, Botella Estrada R. Efectividad en el tratamiento de la urticaria solar con omalizumab: serie de 7 casos. Med Clin (Barc). 2018;151:460–461.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CyA: cyclosporin A; min: minutes; q.d.s.: 4 times a day; PR: partial response; CR: complete response; SU: solar urticaria.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total IgE (U/ml)<span class="elsevierStyleSup">*</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BMI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Time of progression \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Symptoms \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Latency (min) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resolution time (min) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Spectrum of light \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Previous treatment \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Response to omalizumab \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Previous treatment \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Whealing<br>Burning \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (5<span class="elsevierStyleHsp" style=""></span>min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CR (300<span class="elsevierStyleHsp" style=""></span>mg/month)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/month \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Erythema<br>Whealing<br>Pruritus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (10<span class="elsevierStyleHsp" style=""></span>min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CR (300<span class="elsevierStyleHsp" style=""></span>mg/month)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/5 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">531 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Erythema<br>Pruritus<br>Angioedema \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5–10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (10<span class="elsevierStyleHsp" style=""></span>min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CR (450<span class="elsevierStyleHsp" style=""></span>mg/15 days)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/month \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.767 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Whealing<br>Pruritus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (5<span class="elsevierStyleHsp" style=""></span>min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s.<br>CyA 4.5<span class="elsevierStyleHsp" style=""></span>mg/kg/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CR (450<span class="elsevierStyleHsp" style=""></span>mg/15 days)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/month \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Whealing<br>Pruritus<br>Angioedema<br>Dyspnoea \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60–120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (5<span class="elsevierStyleHsp" style=""></span>min)<br>UVA (10<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PR (300<span class="elsevierStyleHsp" style=""></span>mg/month)<br>Phototest:<br>– Negative in visible light<br>– Positive UVA 12<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/month<br>Bilastine 3 tab/day \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Erythema<br>Pruritus<br>Whealing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (5<span class="elsevierStyleHsp" style=""></span>min)<br>UVA (10<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PR (300<span class="elsevierStyleHsp" style=""></span>mg/month)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">300<span class="elsevierStyleHsp" style=""></span>mg/month \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No. 7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Erythema<br>Pruritus<br>Burning \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60–120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Visible light (5<span class="elsevierStyleHsp" style=""></span>min)<br>UVA (6.25<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bilastine q.d.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PR (450<span class="elsevierStyleHsp" style=""></span>mg/15 days)<br>Negative phototest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">450<span class="elsevierStyleHsp" style=""></span>mg/15 days<br>Anti-H1 2 tablet/day \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1915992.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Summary of epidemiological, clinical and therapeutic data in our series of SU patients treated with omalizumab.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term management of chronic spontaneous urticaria with omalizumab" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Pinto Gouveia" 1 => "A. Gameiro" 2 => "A. Pinho" 3 => "M. Gonçalo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ced.13173" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2017" "volumen" => "42" "paginaInicial" => "735" "paginaFinal" => "742" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28649751" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partial response of solar urticaria to omalizumab therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Kowalzick" 1 => "W. Thiel" 2 => "C. Bielfeld" 3 => "H. Ziegler" 4 => "L. Eickenscheidt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00105-016-3913-0" "Revista" => array:7 [ "tituloSerie" => "Hautarzt" "fecha" => "2017" "volumen" => "68" "paginaInicial" => "492" "paginaFinal" => "496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27995273" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0885392417303354" "estado" => "S300" "issn" => "08853924" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Response to Omalizumab in solar urticaria: report of 3 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Rodríguez-Jiménez" 1 => "P. Chicharro" 2 => "A. Pérez-Plaza" 3 => "D. de Argila" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Dermosifiliogr" "fecha" => "2017" "volumen" => "108" "paginaInicial" => "e53" "paginaFinal" => "e55" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Failure of omalizumab in the treatment of solar urticarial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Müller" 1 => "C.M. Schempp" 2 => "T. Jakob" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.12922" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2016" "volumen" => "30" "paginaInicial" => "524" "paginaFinal" => "525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25546321" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three cases of solar urticaria successfully treated with omalizumab" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Baliu-Piqué" 1 => "P. Aguilera Peiró" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.13001" "Revista" => array:7 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2016" "volumen" => "30" "paginaInicial" => "704" "paginaFinal" => "706" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25640906" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0885392417306942" "estado" => "S300" "issn" => "08853924" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015100000011/v1_201812070631/S238702061830425X/v1_201812070631/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015100000011/v1_201812070631/S238702061830425X/v1_201812070631/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702061830425X?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
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| 2023 March | 2 | 2 | 4 |
