Abstract
Background: There is little information on urticaria occurring in children, especially in limited resource countries.
Objective: To determine the demographic and clinical features of urticaria in children living in a developing country.
Patients and method: A prospective study was done in children from two allergy outpatient clinics were prospectively studied. Clinical data was obtained from the medical history and physical examination. Laboratory evaluations and immediate-type skin tests with food and aeroallergen extracts were done in selected cases. Urticaria subtypes were de ned according to current EAACI/GA(2)LEN/WAO guidelines.
Results: One hundred and twenty-three subjects were studied, 71 with acute urticaria and 52 with chronic urticaria. In patients with chronic urticaria, but not in those with acute urticaria, there was a significant predominance of girls. Triggers of urticaria were more common in acute than in chronic urticaria. Insects, foods, and drugs were the most common inducers of symptoms in acute urticaria, while urticaria induced by skin pressure was referred more often in chronic urticaria. In patients with acute or chronic urticaria there was a higher involvement of the head, upper and lower limbs. In patients with chronic urticaria, generalized urticaria, angioedema, and wheals on pressure sites were more frequent than in patients with acute urticaria. Spontaneous, papular, drug-induced, and dermographic urticaria were the most common subtypes in both groups of children.
Conclusions: In children attending allergy services, acute urticaria was more frequent than the chronic type. Symptom triggers were different in acute than in chronic urticaria. Most common subtypes were spon- taneous, papular, drug-induced, and dermographic urticaria.
References
Pite H, Wedi B, Borrego LM, Kapp A, Raap U. Management of childhood urticaria: current knowledge and practical recommendations. Acta Derm Venereol 2013;93:500-508.
Greaves MN. Chronic urticaria in childhood. Allergy 2000;55:309-320.
Grattan CE, O’Donnell BF, Francis DM, et al. Randomized double-blind study of cyclosporin in chronic “idiopathic” urticaria. Br J Dermatol 2000;143:365-372.
Kjaer HF, Eller E, Host A, Andersen KE, Bindlev-Jensen C. The prevalence of allergic diseases in an unselected group of 6 year-old children. The DARC birth cohort study. Pediatr Allergy Immunol 2008;19:737-745.
Khakoo G, Sofianov-Katsoulis A, Perkin MR, Lack G. Clinical features and natural history of physical urticaria in children. Pediatr Allergy Immunol 2008;19:363-366.
Brüske I, Standl M, Weidinger S, et al. Epidemiology of urticarial in infants and young children in Germany. Results from the German LISAplus and GINIplus birth cohort studies. Pediatr Allergy Immunol 2013; nov 17. doi: 10.1111/ pai.12146 [Epub ahead of print].
Gupta R, Sheikh A, Strachan DP, Anderson HR. Time trends in allergic disorders in the UK. Thorax 2007;62:91-96.
Poulos LK, Waters AM, Correll PK, Loblay RH, Marks GB. Trends in hospitalizations for anaphylaxis, angioedema, and urticaria in Australia 1993-1994 to 2004-2005. J Allergy Clin Immunol 2007;120:878-884.
Berttie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol 2006;155:145-151.
Ferrer M. Epidemiologic, healthcare, resources use, and clinical features of different types of urticaria. Allergologica 2005. J Investig Allergol Clin Immunol 2009;19(Suppl 2):21-26.
Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2) LEN/EDF/WAO guideline: Definition, classification and diagnosis of urticaria. Allergy 2009;64:1417-1426.
Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2) LEN/EDF/WAO guideline: Management of urticaria. Allergy 2009;64:1427-1443.
Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A. Aspirin-exacerbated cutaneous disease. Immunol Allergy Clin North Am 2013;33:251-262.
Gupta SP, Jindal N, Gupta S, Mahendra A, Bhaskar G. Clinico-epidemiological study with response to specific treatment in childhood urticaria. Indian Dermatol Online J 2011;2:64-66.
Harris A, Twarog FJ, Geha RS. Chronic urticaria in childhood: Natural course and etiology. Ann Allergy 1983;51:161-165.
Levy Y, Segal N, Weintrub N, Danon YL. Chronic urticaria: Association with thyroid autoimmunity. Arch Dis Child 2003;88:517-519.
Caminiti L, Passalacqua G, Magazzu G, et al. Chronic urticarial and associated coeliac disease in children: A casecontrol study. Pediatr Allergy Immunol 2005;16:428-432.
Sorensen HT, Christensen BC, Kjaerulff E. Urticaria among Danish children in general practice. Scand J Prim Health Care 1985;3:87-89.
Konstantinou GN, Papadopoulos NG, Tavlaraki T, et al. Childhood acute urticaria in Northern and Southern Europe show a similar epidemiological pattern and significant meteorological influences. Pediatr Allergy Immunol 2011;22:36-42.
Weller K, Viehmann K, Braütigam M, et al. Management of chronic spontaneous urticaria in real life – in accordance with the guidelines? A cross-sectional physician-based survey study. J Eur Acad Dermatol Venereol 2013;27:43- 50.
Kauppinen K, Junjunen K, Lanki H. Urticaria in children. Allergy 1984;39:469-472.
Sackesen C, Sekerel BE, Orhan FO, et al. The etiology of different forms of urticaria in childhood. Pediatr Dermatol 2000;21:102-108.
Ehlers I, Niggeman B, Bindev C, Zuberbier T. Role of non allergic hypersensitivity reactions in children with chronic urticaria. Allergy 1998;53:1074-1077.
Volonakis M, Katasaron-Katasari A, Stratigos J. Etiologic factors in childhood chronic urticaria. Ann Allergy 1992;69:61-65.
Mareri A, Adler SP, Nigro G. Herpesvirus-associated acute urticaria: An age matched case-control study. PLOS ONE 2013;8:e85378.
Brunetti L, Francaniula R, Miniello VL, et al. High prevalence of autoimmune urticaria in children with chronic urticaria. J Allergy Clin Immunol 2004;114:922-927.
Godse KV. Autologous serum skin test in children. Indian J Dermatol 2008;53:61-63.
Jiraponsananuruk O, Pongprenksa S, Sangacharoenkit P, Visitsunthorn N, Vichyanond P. Identification of the etiologies of chronic urticarial in children: A prospective study of 92 patients. Pediatr Allergy Immunol 2010;21:508-514.
Du Toit G, Prescott R, Lawrence P, et al. Autoantibodies to the high-affinity IgE receptor in children with chronic urticaria. Ann Allergy Asthma Immunol 2006;96:241- 244.
Marrouche N, Grattan C. Childhood urticaria. Curr Opin Allergy Clin Immunol 2012;12:485-490. 31. Doshi DR, Weinbeger MM. Experience with cyclosporine in children with chronic idiopathic urticaria. Pediatr Dermatol 2009;26:409-413.
Doshi DR, Weinbeger MM. Experience with cyclosporine in children with chronic idiopathic urticaria. Pediatr Dermatol2009;26:409-413.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2014 Revista Alergia México