PEDIATRIC URTICARIA AND ANGIOEDEMA

Abstract

It is estimated that 15% to 25% of the general population experiences at least one episode of acute, transient urticaria or angioedema. Although children are affected frequently, the pfecise incidence in childhood is not known. Urticaria and angioedema should be regarded as symptoms that might be triggered by a wide range of exogenous factors or endogenous disease states with allergic, inflammatory, or infectious mechanisms. though urticaria1 le- sions are typically benign, the intense pruritus and chronicity may produce significant distress. In contrast, angioedema of the upper airway may be life threatening. Regardless, an acute episode of urticaria or angioedema is often frightening to parents and the affected child, prompting consultation with a physician. All too often there is a tendency to assume a casual attitude toward common, benign children's dermatologic problems. Parental anxiety and patient suffering can be serious consequences of dismissing hives as something that will just go away.7 As urticaria can be one symptom of a clinical spectrum, ranging from vasculitis to anaphylaxis, it should be approached in a mechanistic manner with logical protocols. Although the cause of an acute episode is sometimes evident from a care- fully obtained- history, selected laboratory studies are helpful in some cases. In chronic urticaria, an undergying cause is frequently not determined, leading to frustration among patient, parents, and physician. Parents frequently seek the opinion of allergists or dermatologists in the hopes of discovering the cause. Fortunately, acute urticaria is more common in children and young adults while the peak incidence of chronic urticaria is during the third and the fourth decades.