Management of Childhood Urticaria: Current Knowledge and Practical Recommendations

Abstract

Urticaria, defined by the presence of wheals and/or angio-edema, is a common condition in children, prompting parents to consult physicians. For its successful management, paediatric-specific features must be taken into account, regarding the identification of eliciting triggers and pharmacological therapy. This review systematically discusses the current best-available evidence on spontaneous acute and chronic urticaria as well as physical and other urticaria types in children. Potential underlying causes, namely infections, food and drug hypersensitivity, autoreactivity and autoimmune or other conditions, and eliciting stimuli are considered, with practical recommendations for specific diagnostic approaches. Second-generation antihistamines are the mainstay of pharmacological treatment aimed at relief of symptoms, which require dose adjustment for pae-diatric use. Other therapeutic interventions are also discussed. In addition, unmet needs are highlighted, aiming to promote research into the paediatric population, ultimately aiming at the effective management of childhood urticaria.

First Results of Assessing the Quality of Medical Care at Pre-Hospital and Hospital Stages for Children with Acute Allergic Pathology

“…Распространенность острой крапивницы среди дет-ского населения составляет 2,1-6,7% [6]. Результаты 11 европейских исследований демонстрируют увеличение числа госпитализаций с анафилаксией за последние два десятилетия -1,5-7,9 на 100 тыс.…”

The association of cholinergic and cold-induced urticaria: diagnosis and management

“…Cholinergic urticaria presents as itchy pinpoint non-follicular, mainly located on the trunk and upper extremities and the symptoms are aggravated by exercise 10–12. This differs from exercise-induced urticaria/anaphylaxis, which manifests as larger wheals frequently evolving into anaphylaxis 4. The skin lesions in cholinergic urticaria appear immediately, within a few minutes after exercise or passive warming, and typically last 15–60 min 3.…”

“…Physical urticaria has been reported to be responsible for up to 25% of cases of CU3 and is induced by physical factors. Physical urticaria subtypes include dermographism, cold contact, heat contact, delayed pressure, solar and vibratory urticaria 3 4. Cold-induced urticaria accounts for up to one-third of all physical urticarial cases 5.…”

Modern Possibilities of Chronic Urticaria Therapy in Children

“…Хроническая крапивница -заболевание, недооце-ненное по своей тяжести и влиянию на качество жизни детей и подростков, что может быть связано с ее низкой (0,1-3%) распространенностью [3,4]. Хроническая кра-пивница выраженно снижает качество жизни ребенка, ухудшает ночной сон, влияет на успеваемость в школе, в том числе из-за пропусков занятий в связи с частыми обострениями [5,6].…”