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Urticaria in children

What is Urticaria?

Urticaria is one of the most common skin disease, characterized by the development of wheals (hives), swelling of the skin and mucous membranes (mainly at the face, tongue, abdomen, arms and legs), or both of these symptoms and it is classified as acute or chronic form based on the duration of illness.

Causes of Urticaria in Children

  1. Viral infection (in 40% of cases), such as upper respiratory tract infection, viral infections or glandular fever (infectious mononucleosis)
  2. Bacterial infection, such as sinusitis or a dental abscess
  3. Food allergy, usually on or after the first exposure to a particular food such as egg, milk, soy, peanut, and wheat
  4. Drug-induced urticaria, such as that caused by an antibiotic or non-steroidal anti-inflammatory drug (NSAID)
  5. Bee or wasp sting.
  6. There  are  50% of cases of acute urticaria with no known causes called ‘idiopathic’ urticaria.
  7. Chronic urticaria is usually associated with autoimmune disease or a chronic infection. It is rare in children

Symptoms of Urticaria

Urticaria begins to itch locally in the skin at first, and the skin becomes flushed, and a bright red or white wind mass of different shapes, sizes, and violent pruritus occurs. The itch is severe, and it can occur several times within a day. Generally, the rash spreads all over the body, and the mucosa can also be affected.

It can be accompanied by abdominal pain and diarrhea in the gastrointestinal tract. It can occur in the mucous membrane of the larynx causing difficulty in breathing.

Treatment of Urticaria in Children

  1. Urticaria in children is treated with a non-sedating antihistamine, such as cetirizine. This is not curative, but often to  control the itch and the spread of urticaria until it settles on its own.
  2. In severe cases that are unresponsive to antihistamines, oral prednisone may be given for a few days.
  3. Children with urticaria may also be advised to avoid trigger factors, such as triggers for any food or drug allergy, as well as very cold or very hot temperatures .
  4. The itch may be reduced by cooling with a fan, ice pack, or moisturizing lotion.
  5. If there is life-threatening anaphylaxis, an intramuscular injection of adrenaline is advised.

References

  1. Urticaria in children. (n.d.). Retrieved February 10, 2021, from https://dermnetnz.org/topics/urticaria-in-children/
  2. Shin, M., & Lee, S. (2017, May). Prevalence and causes of childhood urticaria. Retrieved February 10, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352569/

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