This woman developed a swollen lower lip after 3 days of Hawaiian sun. She used sunscreen everywhere but her lips! Topical clobetasol ointment TID and no sun reduced the lip to near normal in 24 hours.
Solar angioedema is the development of fixed angioedema in body sites exposed to intense sunlight exposure. Urticarial wheals are not seen.
A report of 5 cases [Int Arch Allergy Immunol 2010;153;315-320] from Italy described angioedematous swelling of exposed skin, e.g., lips, eyelids, hands, and feet which lasted 1-5 days. There was no involvement of the bowels or larynx.
Oral antihistamines are ineffective. For angioedema of the lip, topical clobetasol ointment TID seemed helpful. Of course, further sun exposure should be avoided until the condition remits. After that, sunscreen and sun protection is in order.
Intravenous prednisone 40 mg once shortened the duration of an attack and gave some relief of symptoms.
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