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Evidence-based evaluation and management of chronic urticaria in children
Kristine B Zitelli1, Kelly M Cordoro2,3
1Psoriasis Treatment Center.
Insights
Chronic urticaria (CU) affects many children, often with unknown causes. This study provides a framework to help categorize, evaluate, and treat pediatric chronic urticaria for better patient outcomes.
Area of Science:
- Pediatric Dermatology
- Immunology
- Allergy
Background:
- Urticaria affects a significant portion of the population.
- Chronic urticaria (CU) in children can severely impact quality of life.
- The exact causes of pediatric CU are often unidentified, leading to a designation of chronic idiopathic urticaria.
Purpose of the Study:
- To develop a conceptual framework for the categorization, clinical evaluation, and treatment of chronic urticaria in children.
- To address the clinical complexities and literature confusion surrounding pediatric CU.
- To provide evidence-based guidance for managing chronic urticaria in pediatric populations.
Main Methods:
- Literature review and synthesis of cumulative evidence.
- Development of a conceptual framework.
- Analysis of proposed causes and triggers for pediatric CU.
Main Results:
- Identified numerous proposed causes and triggers for pediatric CU, including infections, allergens, medications, physical factors, and autoimmune disease.
- Highlighted the frequent lack of identifiable etiology, resulting in 'chronic idiopathic urticaria' diagnoses.
- Established a framework to aid in the systematic approach to pediatric CU.
Conclusions:
- A structured approach is needed to manage the complexities of pediatric chronic urticaria.
- The proposed framework can assist clinicians in evaluating and treating children with CU.
- Further research may elucidate the specific etiologies in cases currently designated as idiopathic.
Abstract:
Urticaria affects nearly 25% of the population at some time in their lives. In a subset of children, urticaria will develop into a chronic condition that can greatly affect quality of life. Although numerous causes and triggers are proposed for chronic urticaria (CU) in children, ranging from infections, allergens, and medications to physical factors and autoimmune disease, the exact etiology is not always identifiable. Accordingly, a large subset of cases are designated "chronic idiopathic urticaria." Because of the clinical complexities of CU, as well as the confusing literature on this topic, we have developed a conceptual framework based on the cumulative evidence to assist with the categorization, clinical evaluation, and treatment of CU in children.
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