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Pediatricians' approach to children with acute urticaria
Tuba Tuncel1, Pinar Uysal, Zeynep Arikan-Ayyildiz
1Division of Allergy, Department of Pediatrics, Dokuz Eylul University Hospital, Izmir, Turkey - ttuncel@yahoo.com.tr.
Insights
Pediatricians often misidentify food triggers for acute urticaria in children and use partially correct treatments. Their knowledge of diagnosis and management needs improvement for better pediatric allergy care.
Area of Science:
- Pediatric Allergy and Immunology
- Dermatology
- Clinical Pediatrics
Background:
- Acute urticaria is a prevalent childhood condition causing concern for families and healthcare providers.
- Understanding pediatricians' current management strategies is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the general approach, knowledge, and practical management of acute urticaria by pediatricians.
- To identify potential gaps in the understanding and treatment of pediatric urticaria.
Main Methods:
- A 17-question data collection form evaluated pediatricians' and pediatric residents' knowledge and practices.
- Statistical analysis included frequency counts, Pearson chi-square, and Fisher's exact tests.
- The study received local ethics committee approval.
Main Results:
- Pediatricians frequently cite foods/additives as causes and recommend dietary changes.
- Second-generation antihistamines for 5-7 days are the preferred treatment; residents favored parenteral administration.
- Referrals to allergists occur for angioedema or treatment-resistant cases.
Conclusions:
- Pediatricians' knowledge of acute urticaria diagnosis and treatment is less comprehensive than anticipated.
- Confusion exists regarding the specific role of foods and dietary elimination strategies.
- While treatment approaches are partially adequate, there's a need for enhanced physician education, particularly concerning dietary management.
Background:
Acute urticaria is a common condition in childhood that concerns both patients and pediatricians. The aim of this study was to evaluate the general approach of pediatricians to children with acute urticaria.
Methods:
A data collection form consisting of 17 questions was created to evaluate pediatricians' general knowledge and practical approaches about urticaria. This form was distributed at the hospitals where pediatricians and pediatric residents work. The data was recorded in SPSS for Windows v.15 (SPSS, Inc., Chicago, IL, USA). The frequency (%) was used for descriptive data, while Pearson χ2 and Fisher's Exact tests were used for comparisons between groups. P<0.05 was considered significant. The study was approved by the local ethics committee.
Results:
Pediatricians suggest that foods and food additives are the most common etiological factors in the development of urticaria and, therefore, often advise dietary changes. Second-generation antihistamines are preferred for treatment and are administered for about 5-7 days. Pediatric residents were found to prefer parenteral drug administration for the treatment of urticaria. A different generation antihistamine therapy was applied for treatment of patients who did not respond to the initial treatment. It was also determined that patients were referred to allergists when urticaria was accompanied by angioedema or when patients were resistant to conventional treatment.
Conclusions:
Pediatricians' knowledge regarding the diagnosis and treatment of urticaria was less extensive than expected. According to the results, there was some confusion among physicians regarding the etiological role of some foods in acute urticaria and the strategies for removal of these foods from the diet during the treatment. Participants' treatment approaches were partially correct and sufficient. In general, there were no differences observed between pediatric residents and pediatricians in terms of the management of patients with urticaria, except the route of administration.
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