Patients with psoriasis should undergo regular eye exams, regardless of risk factors, to monitor for the progression of symptomatic or asymptomatic ocular manifestations.

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Urticaria diagnosis may be challenging in children since it can be triggered or related to numerous conditions. In this paper, we reviewed the main aspects regarding the diagnosis of urticaria in the pediatric population. Acute urticaria is often due to viral infections. However, other culprits, including foods, insect stings, drugs, contrast media, vaccination, latex, and medical diseases, may account for acute patterns. Laboratory tests and confirmatory allergy tests should be individualized and guided by history. Chronic urticaria (CU) is defined when hives and/or angioedema last for more than 6 weeks. The most common type of chronic urticaria in children is chronic spontaneous urticaria (CSU). Chronic inducible urticaria (CindU) is less common but is important to diagnose in order to manage appropriately and reduce the risk of severe reactions. Inducible forms in children are often diagnosed with specific provocation tests similar to the tests used in adults. Given that chronic urticaria could rarely be a presentation of vasculitis, systemic-onset juvenile idiopathic arthritis, or auto-inflammatory syndromes, it is important to rule out these conditions. It is crucial to differentiate cases of chronic urticaria from mastocytosis and Bradykinin-mediated angioedema, given that treatment may differ. The management of chronic urticaria in children has improved over the last decade because of the development of both clear management guidelines and new effective drugs. It is crucial to increase awareness for appropriate diagnosis and new available treatment to improve the management of chronic urticaria in children.

RATIONALE: Drug hypersensitivity reactions (DHR) affect about 7% of the general population; they may be unpredictable and represent a lifethreatening risk. The study aimed to analyze the clinical profile and possible differences between children and adults that presented a DHR. METHODS: Retrospective data analysis of patients evaluated in 10 specialized centers in Brazil, from March 2016 to June 2018. Cases with probable or confirmed diagnosis were included. Children (less than 18 years old) and adults were compared according to clinical and epidemiological data, and a 5% level of significance was established (p<0,05). RESULTS: Eighty-one percent of patients (262/321) had a probable or confirmed diagnosis of DHR. Female gender was predominant in adults (83%) and children (55%). Immediate reactions were more frequent in adults (68%) than in children (48%), where non-immediate reactions were prevailing (52%). Fever and/or infectious diseases were observed in 59% of children with DHR, compared to 12% of adults. NSAIDs were reported as the culprit drug in 74% of adults and 53% of children. On the other hand, antibiotics were involved in 46% of the reactions in children, but just in 12% of adults. There were no significant differences between groups regarding clinical presentation, severity of symptoms, personal history of atopy or family history of DHR. CONCLUSIONS: The DHR profile in adults and children differs in time to reaction, presence of related co-factors and drugs involved. These differences may represent essential tools to help the diagnosis and management of DHR in clinical practice.

RATIONALE: Drug hypersensitivity reactions (DHR) are a public health problem, but there are few studies in Brazilian pediatric population. This study analyzes and describes potential factors associated with severity of DHR in children. METHODS: Retrospective data analysis of 235 patients under 18 years old, evaluated in 8 specialized centers in Brazil, from 2009 to April 2018. Patients with a probable or confirmed diagnosis of DHR were included. Patients were classified according to characteristics of the reaction in nonsevere (only cutaneous manifestation), and severe (cutaneous manifestation and involvement of other organs or systems). A 5% level of significance was established. RESULTS: The majority of patients (235/262) had a probable or confirmed diagnosis of DHR, and in 39% the reactions were considered severe. Severity was significantly associated with an atopic background for patients presenting immediate reactions. Severe reactions were observed more frequently in older children (> _6 years). Fever or infectious disease was present in 59% of children at the time of reaction, and in 39% of them, the reaction was severe. NSAIDs were reported as the culprit drug in 59% of cases and beta-lactam antibiotics in 32%, but no drug class association with severity was observed. There were no significant differences in severity considering patient's gender and family history of DHR. CONCLUSIONS: Atopic children and patients older than 6 was associated showed a higher risk for severe DHR. Co-factors as infections and fever may also be involved in severity and more extensive studies would be useful to determine other factors. Abstracts AB161 SUNDAY