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Exploring treatment options for pediatric refractory chronic urticaria
Maria Kostara1,2, Chrysoula Kosmeri2, Emek Kocatürk3,4,5
1Child Health Department, School of Medicine, University of Ioannina, Ioannina, Greece.
Expert Review of Clinical Immunology
|July 24, 2025
Summary
Chronic urticaria (CU) significantly impacts children
Area of Science:
- Pediatric Dermatology
- Immunology
- Allergy
Background:
- Urticaria is an inflammatory skin condition affecting 1.4% globally.
- Chronic urticaria (CU) significantly impacts children's quality of life.
- Refractory CU in children does not respond to standard antihistamines.
Purpose of the Study:
- To review the stepwise treatment approach for pediatric refractory CU.
- To highlight challenges in managing chronic urticaria in children.
- To emphasize the need for ongoing research in pediatric urticaria.
Main Methods:
- Review of current treatment guidelines for pediatric urticaria.
- Analysis of first-line, second-line, and emerging therapies.
- Discussion of management strategies for antihistamine-refractory cases.
Main Results:
- First-line treatment involves second-generation H1-antihistamines with dose escalation.
- Omalizumab is recommended for antihistamine-refractory CU.
- Emerging therapies show promise but require further pediatric research.
Conclusions:
- A stepwise approach is crucial for managing pediatric refractory CU.
- Optimizing treatment strategies is essential for improving patient outcomes.
- Further research is needed to address treatment challenges in pediatric populations.
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