The Etiology of Different Forms of Urticaria in Childhood

Hacettepe University, Engüri, Ankara, Turkey
Pediatric Dermatology (Impact Factor: 1.02). 02/2004; 21(2):102-8. DOI: 10.1111/j.0736-8046.2004.21202.x
Source: PubMed


Urticaria is a common disease in children. In contrast to the ease of its diagnosis, etiologic factors are often difficult to determine. In order to study whether differences exist among various forms of urticaria in childhood and whether the patterns of different types of urticaria differ between adults and children, we extensively studied the possible causes of urticaria in children. Fifty-four children (23 girls and 31 boys; ages 1-19 years) with various forms of urticaria were included in the study. In all cases, questions about food allergies, food additive intolerance, drug intake, signs of infection, causes of physical urticaria, insect bites, and personal and family history of atopy were asked. Clinical characteristics of the disease, such as duration, recurrence, and associated angioedema and symptoms of anaphylaxis were also investigated. Detailed laboratory tests, including serologic, autoimmune, and allergic analyses, were conducted to reveal the probable etiologies of urticaria. Of the study patients, 68.5% and 31.5% were diagnosed as having acute and chronic urticaria, respectively. The patient group with chronic urticaria was older and included more boys than the acute group. In the acute urticaria group, infection was the most frequently documented cause (48.6%), followed by drugs (5.4%), and food allergies (2.7%), whereas in chronic urticaria, physical factors were the leading cause (52.94%). The most frequently documented infection was urinary tract infection, followed by serologically determined infections of Chlamydia pneumoniae and Helicobacter pylori. In this study we found indications that infections were frequently associated with urticaria, which suggests that urticaria management should include a survey of certain infectious agents in addition to a detailed history.

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    • "Urticaria is a common disease in children and is estimated to affect 15-25% of people at some point in their lives [1-3]. Symptoms of urticaria (e.g., recurrent itching, generalized wheals and sleep disturbances) can persist for several days to months and are a significant source of patient stress [1-8]. "
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    ABSTRACT: Background Non-infection caused urticaria is a common ailment in adolescents. Its symptoms (e.g., unusual rash appearance, limitation of daily activities, and recurrent itching) may contribute to the development of depressive stress in adolescents; the potential link has not been well studied. This study aimed to investigate the risk of major depression after a first-attack and non-infection caused urticaria. Methods This study used the Taiwan Longitudinal Health Insurance Database. A total of 5,755 adolescents hospitalized for a first-attack and non-infection caused urticaria from 2005 to 2009 were recruited as the study group, together with 17,265 matched non-urticarial enrollees who comprised the control group. Patients who had any history of urticaria or depression prior to the evaluation period were excluded. Each patient was followed for one year to identify the occurrence of depression. Cox proportional hazards models were generated to compute the risk of major depression, adjusting for the subjects’ sociodemographic characteristics. Depression-free survival curves were also analyzed. Results Thirty-four (0.6%) adolescents with non-infection caused urticaria and 59 (0.3%) non-urticarial control subjects suffered a new-onset episode of major depression during the study period. The stratified Cox proportional analysis showed that the crude hazard ratio (HR) of depression among adolescents with urticaria was 1.73 times (95% CI, 1.13-2.64) than that of the control subjects without urticaria. Moreover, the HR were higher in physical (HR: 3.39, 95% CI 2.77-11.52) and allergy chronic urticaria (HR: 2.43, 95% CI 3.18-9.78). Conclusion Individuals who have a non-infection caused urticaria during adolescence are at a higher risk of developing major depression.
    Full-text · Article · Jul 2014 · BMC Pediatrics
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    • "Acute urticaria is considered as a classical manifestation of viral infection in general, especially in children [7,11,12] but also in adults. Recent data found infections to be the most common identified cause (37%) [13]. "
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    ABSTRACT: Urticaria is a group of diseases that share a distinct skin reaction pattern. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. In spontaneous acute urticaria there is no doubt for a causal relationship to infections and all chronic urticaria must have started as acute. Whereas in physical or distinct urticaria subtypes the evidence for infections is sparse, remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Current summarizing available studies that evaluated the course of the chronic urticaria after proven Helicobacter eradication demonstrate a statistically significant benefit compared to untreated patients or Helicobacter-negative controls without urticaria (p < 0.001). Since infections can be easily treated some diagnostic procedures should be included in the routine work-up, especially the search for Helicobacter pylori. This review will update the reader regarding the role of infections in different urticaria subtypes.
    Full-text · Article · Dec 2009 · Allergy Asthma and Clinical Immunology
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    ABSTRACT: Introducción Los corticoides sistémicos son medicamentos muy ampliamente utilizados en la Dermatología general. Son muy eficaces como antiinflamatorios de amplio espectro y su uso juicioso aporta grandes beneficios a los pacientes. Sin embargo, los efectos secunda-rios de los corticoides sistémicos limitan su utilización, aunque el correcto conocimiento de dichos efectos adversos y su adecuado manejo pueden permitir la utilización de los corticoides con un amplio margen de seguri-dad en la mayoría de los pacientes, cualquiera sea su edad. En muchas ocasiones el dermatólogo pediátri-co se enfrenta ante la necesidad de utilizar tra-tamientos de choque para dermatosis agudas Resumen Abstract Corticosteroids are drugs widely used in pediatric dermatology, for that we should know about their properties and indications. Systemic therapy with corticosteroids vary from pulse therapy to different oral schedules for diverse dermatological disease.
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