Acute Urticaria in Children: Causes and Treatment Options

Acute urticaria

Hello, doctor: My daughter has had a history of developing hives whenever her skin is scratched or lightly touched since she was young, but they usually resolve quickly.
A doctor diagnosed her with urticaria, which cannot be cured.
Last week, she experienced a full-body outbreak, referred to as acute urticaria.
We went to a large hospital and received medication, which helped reduce the symptoms, but the next day, after missing one dose, her condition flared up completely.
Taking the medication again did not improve her situation, and despite receiving glucose injections, her condition still did not improve.
It has been a week since the onset of her symptoms, and I am at a loss about what to do.

yoyo, 30~39 year old female. Ask Date: 2005/11/12

Dr. Zhang Guozhen reply Pediatrics

Dermatographism, also known as skin writing, is a type of urticaria.
Urticaria is a skin condition characterized by the appearance of raised welts similar to mosquito bites or widespread skin swelling.
There are many causes of urticaria, including common medications, foods, viral infections, dust, and a significant category triggered by physical and external stimuli known as physical urticaria.
These stimuli include vibration, pressure, cold, heat, sunlight, and even contact with water.
Dermatographism is the most common form of physical urticaria, where scratching, rubbing the skin with a towel, or minor skin injuries can lead to itching and hives.

In terms of treatment, if the itching symptoms are not pronounced, treatment is usually not necessary.
If the patient is very sensitive and reacts to even minor skin stimuli, oral antihistamines can be used effectively.
For more severe cases, continuous low-dose antihistamines may be required to control the condition and reduce itching.
Treatment duration may sometimes need to be 1-2 weeks to be sufficient.

Reply Date: 2005/11/12

More Info

Acute urticaria, commonly known as hives, is a condition characterized by the sudden appearance of itchy welts on the skin. In children, this can be particularly distressing, both for the child and the parents. Understanding the causes and treatment options for acute urticaria is crucial for effective management.

Causes of Acute Urticaria in Children
Acute urticaria can be triggered by a variety of factors, including:
1. Allergic Reactions: Common allergens include foods (such as nuts, eggs, and shellfish), medications (like antibiotics and non-steroidal anti-inflammatory drugs), and insect stings.

2. Infections: Viral infections, particularly those that are common in children, can lead to hives. This includes respiratory infections, gastroenteritis, and even some bacterial infections.

3. Physical Triggers: Factors such as pressure on the skin, temperature changes (heat or cold), sunlight exposure, and even exercise can induce hives in susceptible individuals.

4. Stress: Emotional stress can also play a role in the onset of hives, particularly in children who may not express their feelings verbally.

5. Idiopathic: In many cases, the exact cause of acute urticaria remains unknown, which can be frustrating for parents and healthcare providers alike.

Treatment Options
The management of acute urticaria primarily focuses on alleviating symptoms and identifying potential triggers. Here are some common treatment strategies:
1. Antihistamines: These are the first-line treatment for hives. Non-sedating antihistamines, such as cetirizine or loratadine, are often recommended for children. They work by blocking the action of histamine, a substance in the body that causes allergic symptoms.

2. Corticosteroids: In cases of severe urticaria that do not respond to antihistamines, a short course of oral corticosteroids may be prescribed to reduce inflammation and itching.

3. Avoidance of Triggers: Identifying and avoiding known triggers is essential. Keeping a diary of food intake, medications, and activities can help pinpoint what may be causing the hives.

4. Supportive Care: Cool compresses and soothing lotions can provide relief from itching. Keeping the child’s skin moisturized may also help prevent flare-ups.

5. Emergency Care: If the child experiences difficulty breathing, swelling of the face or throat, or other signs of anaphylaxis, immediate medical attention is necessary.

When to Seek Further Medical Attention
If your daughter has been experiencing acute urticaria for a week without improvement, it is essential to follow up with a healthcare provider. Persistent hives may require further investigation to rule out underlying conditions or to adjust the treatment plan.
1. Referral to a Specialist: If the condition does not improve with standard treatments, a referral to an allergist or dermatologist may be warranted. They can perform specific tests to identify allergens or other underlying issues.

2. Consideration of Other Conditions: In some cases, chronic urticaria or other dermatological conditions may mimic acute urticaria. A thorough evaluation can help clarify the diagnosis.

3. Long-term Management: If your daughter continues to have episodes of hives, a long-term management plan may be necessary, which could include regular antihistamine use or other medications.

Conclusion
Acute urticaria in children can be distressing, but with appropriate management, symptoms can often be controlled effectively. It is crucial to work closely with healthcare providers to identify triggers and develop a tailored treatment plan. If symptoms persist or worsen, seeking further medical evaluation is essential to ensure your child's health and well-being.

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