[Urticaria and angioedema in children]

Area of Science:

• Pediatric Dermatology
• Allergy and Immunology

Context:

• Urticaria and angioedema are prevalent conditions in pediatric populations.
• These conditions frequently co-occur and present diagnostic challenges.

Purpose:

• To provide a comprehensive overview of pediatric urticaria and angioedema.
• To discuss current understanding of pathophysiology, clinical presentation, diagnostic approaches, and management strategies.

Summary:

• Urticaria results from mast cell degranulation triggered by diverse factors, including infections, allergies, and autoimmune mechanisms in chronic cases.
• Acute urticaria often links to infections or allergies, while chronic urticaria increasingly points to autoimmune involvement via autoantibodies.
• Diagnostic workup should be guided by clinical history, with allergy testing and provocation tests used judiciously; extensive investigations are rarely beneficial.
• Non-sedating antihistamines are the primary pharmacotherapy, offering significant symptom control until spontaneous resolution.

Impact:

• Informs clinicians on effective diagnostic and therapeutic strategies for pediatric urticaria and angioedema.
• Highlights the shift towards recognizing autoimmune underpinnings in chronic urticaria.
• Emphasizes the role of antihistamines as first-line treatment for symptom management.