4.4 Review

An update on childhood urticaria and angioedema

Journal

CURRENT OPINION IN PEDIATRICS
Volume 20, Issue 4, Pages 425-430

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOP.0b013e328305e262

Keywords

acute urticaria; autoinflammatory urticarial syndrome; autologous serum skin test; chronic urticaria; cold urticaria; hereditary angioedema; histamine release-urticaria test; omalizumab; second generation antihistamine; urticaria

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Purpose of review The present review serves to address urticaria - both acute and chronic - as well as the differential diagnosis of urticarial syndromes in the pediatric population. We also wish to update the reader on progress in the pathophysiology, diagnosis and treatment of urticaria. Recent findings Acute and chronic urticaria represent syndromes caused by a variety of triggers. Recent literature continues to describe subtypes of urticaria that may be differentially responsive to particular therapies. Recent associations highlight the need to fully evaluate patients for allergic and infectious triggers of urticaria. It is important to distinguish idiopathic urticaria from related conditions such as anaphylaxis, systemic conditions and autoimmune urticaria. Although antihistamines remain a cornerstone of therapy, particular urticaria subtypes may also respond to novel therapies such as omalizumab. Chronic urticaria has a significant impact on a patient's quality of life. Summary Urticaria is a common condition. Our understanding of distinct urticaria subtypes differentially responsive to targeted therapies continues to increase. Due to the myriad of triggers that may cause urticaria, careful individualized patient assessment is necessary to exclude potential etiologies prior to a diagnosis of idiopathic urticaria.

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