ACUTE URTICARIA IN CHILDREN - APPROACH TO DIAGNOSIS AND TREATMENT

Thi Ngoc Nguyen1, Thi Ngoc Nguyen1, Anh Tuan Tran1, Huu Nguyet Diem Phan2, Anh Tuan Nguyen2
1 Children’s Hospital 1
2 University of Medicine and Pharmacy

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Abstract

Acute urticaria in children is a common dermatological condition, primarily characterized by the sudden onset of wheals and intense pruritus, which may be accompanied by angioedema. The condition typically resolves within 24 hours but may persist for up to 6 weeks. Causes of acute urticaria include infections, food or drug allergies, and physical triggers; however, the majority of cases have no identifiable etiology. Diagnosis is based on a detailed medical history and clinical examination, with further testing warranted only when serious underlying causes, such as allergies or systemic diseases, are suspected. Treatment focuses on symptom management, with second-generation H1 antihistamines being the preferred first-line therapy. Corticosteroids are reserved for severe cases or those unresponsive to standard treatment. Patient and family education on avoiding potential triggers is essential for preventing recurrences and improving quality of life.

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References

1. Zuberbier T, Aberer W, Asero R et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2022;77(2):734-764. https://doi.org/10.1111/all.13397
2. Buske I, Standl M, Weidinger S et al. Epidemiology of urticaria in infants and young children in Germany–Results from the German LISAplus and GINIplus Birth Cohort Studies. Pediatr Allergy Immunol 2014;25(1):36-42. https://doi.org/10.1111/pai.12146
3. Mortureux P, Léauté-Labrèze C, Legrain-Lifermann V et al. Acute urticaria in infancy and early childhood: a prospective study. Arch Dermatol. 1998;134(3):319-323. https://doi.org/10.1001/archderm.134.3.319
4. Santa C, Valente CL, Mesquita M et al. Acute urticaria in children: from pediatric Emergency Department to allergology consultation at a Central Hospital. Eur Ann Allergy Clin Immunol 2022;54(4):168-174. https://doi.org/10.23822/eurannaci.1764-1489.204
5. Ricci G, Giannetti A, Belotti T et al. Allergy is not the main trigger of urticaria in children referred to the emergency room. J Eur Acad Dermatol Venereol 2010;24(11):1347-1348. https://doi.org/10.1111/j.1468-3083.2010.03634.x
6. Ryan D, Tanno LK, Angier E et al. Clinical review: The suggested management pathway for urticaria in primary care. Clin Transl Allergy 2022;12(10):e12195. https://doi.org/10.1002/clt2.12195
7. Talarico V, Cavallucci E, Viola P et al. New insights in acute and chronic urticaria: what’s new about it?. Acta Biomed 2021;92(S2):1-27.
8. Mathelier-Fusade P. Place du bilan allergologique dans l'urticaire [Interest of allergy tests in urticaria]. Ann Dermatol Venereol 2014;141(Suppl 3):S565-S569. https://doi.org/10.1016/S0151-9638(14)70159-0
9. Wollam J, Solomon M, Villescaz C et al. Inhibition of mast cell degranulation by novel small molecule MRGPRX2 antagonists. J Allergy Clin Immunol 2024;154(4):1033-1043. https://doi.org/10.1016/j.jaci.2024.07.002
10. Roy S, Chompunud Na Ayudhya C, Thapaliya M et al. Multifaceted MRGPRX2: New insight into the role of mast cells in health and disease. J Allergy Clin Immunol 2021;148(2):293-308. https://doi.org/10.1016/j.jaci.2021.03.049
11. Minasi D, Manti S, Chiera F et al. Acute urticaria in the infant. Pediatr Allergy Immunol 2020;31(Suppl 26):49-51. https://doi.org/10.1111/pai.13350
12. Yıldırım G, Ozceker D, Kaçar A et al. Can urticaria severity be used as a biomarker for transition from acute to chronic urticaria?. Pediatr Allergy Immunol 2025;36(3):e70053. https://doi.org/10.1111/pai.70053
13. Nettis E, Foti C, Ambrifi M, et al. Urticaria: recommendations from the Italian Society of Allergology Asthma and Clinical Immunology and the Italian Society of Allergological Occupational and Environmental Dermatology. Clin Mol Allergy 2020;18:8. https://doi.org/10.1186/s12948-020-00123-8
14. Muraro A, Worm M, Alviani C et al. EAACI guidelines: anaphylaxis (2021 update). Allergy 2022;77(2):357-377. https://doi.org/10.1111/all.15032