Pediatric Urticaria: Causes, Symptoms, Treatment, and Prevention

Pediatric Urticaria

Urticaria, commonly known as hives, can be caused by various factors, including allergic reactions, infections, stress, and certain medications.
The severity of symptoms can vary from mild itching and redness to more severe reactions, such as angioedema or anaphylaxis.
Treatment options typically include antihistamines to relieve itching and swelling, corticosteroids for more severe cases, and avoiding known triggers.
In some instances, immunotherapy may be considered for chronic cases.
As for prevention, it is essential to identify and avoid known triggers, maintain a healthy lifestyle, and manage stress levels.
Regarding health supplements sold by direct sales companies, they could potentially be a cause of urticaria if they contain allergens or substances that provoke an immune response in susceptible individuals.
It is advisable to consult a healthcare professional before starting any new supplement, especially for those with a history of allergies or skin conditions.

Ke Xiansheng, 30~39 year old female. Ask Date: 2007/06/29

Dr. Wang Weijie reply Internal Medicine

Dear Mr.
Ke,
(1) Urticaria, commonly known as hives, is characterized by raised, itchy red welts that often have distinct snake-like borders, with a central area that may fade.
The size of the welts can vary, and many people have experienced urticaria at some point.
(2) The causes of urticaria can include food, medications, insect stings, and preservatives found in food additives; however, some causes remain unclear.
Common triggers for urticaria include: A.
Food: seafood, fermented foods, products containing artificial additives (such as canned goods, synthetic beverages, snacks, instant noodles), nuts, caffeinated foods, alcoholic beverages, mangoes, strawberries, grapefruits, eggs, milk, shiitake mushrooms, and bamboo shoots.
B.
Medications: virtually any medication can potentially cause urticaria, with common culprits being analgesics (such as aspirin) and antibiotics.
C.
Infections: chronic dental issues, periodontal disease, sinusitis, colds, urinary tract infections, hepatitis B or C, and intestinal parasitic infections.
D.
Inhalants: pollen, mold spores, dust, and animal dander.
E.
Endocrine factors: thyroid dysfunction and autoimmune diseases.
F.
Physical factors: scratching, sunlight, temperature changes, stress, exercise, and water exposure.
(3) Most cases of urticaria are not severe and will resolve within 48 hours after using antihistamines and avoiding the allergen.
However, a small number of individuals may experience severe allergic reactions such as anaphylaxis or respiratory distress, which can be life-threatening and require immediate treatment with epinephrine or corticosteroids.
(4) Prevention of urticaria includes: A.
Avoiding foods that are known to trigger urticaria; chronic sufferers should maintain a food diary to track the timing and severity of urticaria episodes to identify potential food allergens.
B.
If urticaria has previously occurred due to medication, consult a physician and document any suspected medications to inform the doctor of potential allergies.
C.
Be vigilant for signs of chronic inflammation or infection (such as toothache, cold symptoms, burning sensation during urination, or gastrointestinal discomfort) and seek prompt medical treatment.
D.
For those allergic to pollen, avoid planting flowers or arranging floral displays; for those allergic to animal dander, refrain from keeping pets; avoid areas with high dust and smoke levels; and ensure proper ventilation indoors.
(5) Any food can potentially cause urticaria, including health products sold by direct sales companies.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Ren-Sheng
Director, Pediatrics Department
Taoyuan Hospital, Department of Health

Reply Date: 2007/06/29

More Info

Pediatric urticaria, commonly known as hives, is a skin condition characterized by raised, itchy welts or bumps on the skin. Understanding its causes, symptoms, treatment options, and prevention strategies is crucial for managing this condition effectively in children.

Causes
Urticaria can be triggered by a variety of factors. In children, common causes include:
1. Allergic Reactions: Foods (such as nuts, eggs, and shellfish), medications (like antibiotics and non-steroidal anti-inflammatory drugs), and insect stings can provoke allergic responses leading to hives.

2. Infections: Viral infections, particularly in young children, can trigger urticaria. Bacterial infections and parasitic infestations may also be culprits.

3. Environmental Factors: Changes in temperature, sunlight exposure, and pressure on the skin can induce hives.
4. Stress: Emotional stress can exacerbate or trigger hives in some children.

5. Chronic Conditions: In some cases, underlying chronic conditions such as autoimmune diseases can lead to persistent urticaria.

Regarding your question about health supplements from direct sales companies, while these products can sometimes contain allergens or ingredients that may trigger urticaria, it is essential to evaluate each product individually. Some children may have sensitivities to specific components in these supplements, but not all will react adversely. Consulting with a healthcare provider before introducing any new supplement is advisable.

Symptoms
The primary symptom of urticaria is the appearance of raised, itchy welts on the skin. These can vary in size and may appear anywhere on the body. Other symptoms may include:
- Swelling (angioedema) in deeper layers of the skin, often around the eyes and lips.

- A burning or stinging sensation in addition to itching.

- In severe cases, urticaria can be associated with anaphylaxis, a life-threatening allergic reaction that requires immediate medical attention.

Treatment
Treatment for pediatric urticaria typically involves:
1. Antihistamines: Over-the-counter or prescription antihistamines are the first line of treatment. They help alleviate itching and reduce the appearance of hives.

2. Avoidance of Triggers: Identifying and avoiding known triggers is crucial. Keeping a diary of food intake, medications, and activities can help pinpoint causes.

3. Corticosteroids: In cases of severe or persistent urticaria, a doctor may prescribe corticosteroids to reduce inflammation.

4. Epinephrine: For children with a history of severe allergic reactions, carrying an epinephrine auto-injector is essential.

Prevention
Preventing urticaria involves several strategies:
1. Identify and Avoid Triggers: Work with a healthcare provider to identify specific allergens or irritants that may provoke hives.

2. Maintain a Healthy Environment: Reducing exposure to potential allergens in the home, such as dust mites, pet dander, and mold, can help.

3. Educate on Stress Management: Teaching children coping mechanisms for stress can be beneficial, as stress can exacerbate symptoms.

4. Regular Follow-ups: Regular consultations with a pediatric allergist or dermatologist can help manage and monitor the condition effectively.

In conclusion, pediatric urticaria can arise from various causes, and while it can be distressing for both the child and the parents, it is often manageable with appropriate treatment and preventive measures. If your child experiences recurrent or severe hives, it is essential to consult a healthcare professional for a comprehensive evaluation and tailored management plan.

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