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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
PubMed

Insights

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.
Abstract

Keywords:
Chronic refractory urticariaantihistamineschildrennew treatmentsomalizumabpediatric urticariatreatment

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