Urticaria in children and adolescents: An updated review of the pathogenesis and management

Abstract

The present survey represents the latest data on diagnosis and management of childhood urticaria. It has been observed that urticaria occurs less often in children than adults, with symptoms rarely lasting for over 6 weeks. Triggers or aggravating factors can be found only in 21%-55% of cases. Finding autoantibodies in children does not impact a disease prognosis, unlike in adult patients, where the presence of autoantibodies is associated with a more prolonged run of the disease, a more severe prognosis and more intensive treatment methods. The incidence of food allergy equals to 8%-10% of cases. The incidence of Helicobacter Pylori infection in children is lower than that in adults and comes to 10%-18%. Medical experts recommend using the same treatment schemes for adults and children. This survey describes different urticaria management patterns suggested by experts from Europe, America, and Russia in their recent guidelines. It has been noted that unlike the guidelines from 2014, the 2018 clinical practice guidelines for the diagnosis and management of urticarial once again suggest a four-step treatment scheme with assigning omalizumab for Step 3 and cyclosporine A for Step 4 in the event of low therapeutic efficacy of the previous step or its impossibility. Leukotriene antagonists (LTRAs) are currently removed from basic management to alternative programs.

Prevalence and potential risk factors of urticaria in the Polish population of children and adolescents

“…The overall incidence of urticaria in children and adolescents observed in our study is similar to that of the European population [ 5 ]. Yet a higher incidence of urticaria in the younger age group may suggest an upward trend in the incidence of this disease in the near future.…”

“…In Europe urticaria is rarely encountered in childhood (3.4% the UK, 4.4% Germany, 5.4% Denmark) and chronic urticaria is even less probable (0.1–0.3%) [ 5 ]. However, according to recent data, the prevalence of chronic urticaria in children in other parts of the world is higher (0.7% chronic continuous urticaria and 1.1% chronic recurrent urticaria) [ 6 – 8 ].…”

Dermatological manifestations of the Coronavirus disease 2019 in children: a systemic review

“…Urticaria is a rare disease in childhood (3.4% UK, 4.4% Germany, 5.4% Denmark) and the risk of transformation into a chronic form is negligible (0.1-0.3%) [44][45][46]. Scientific studies show that viral infections can also be an etiological factor in urticaria [47,48].…”

Bilastine: a lifetime companion for the treatment of allergies

“…The prevalence of rhinoconjunctivitis appears to be increasing, particularly among older children 2 . The prevalence of acute urticaria in children is 1-14%, and that of persistent or chronic urticaria is 0.1-1.8% 77,78 . Allergic rhinitis and urticaria both have an adverse effect on QoL in children and adolescents, causing emotional and practical problems, limitations in daily activities and sleep problems [79][80][81][82] .…”