Some claim hives are caused by wind exposure, while others attribute them to "food lumps" resulting from consuming allergenic meals. In reality, numerous factors trigger hives. Let's explore the causes of pediatric urticaria:
Causes of Pediatric Urticaria:
1. Food.Both animal-based foods (e.g., fish, shrimp, crab, eggs, beef, lamb, dairy products) and plant-based foods (e.g., pineapple, mushrooms, broad beans, garlic, strawberries, tomatoes) can trigger hives, though animal products and dairy are more common culprits.Food additives found in children's favorite treats like cold drinks, sodas, ice cream, pastries, and chocolate are often overlooked triggers for chronic urticaria due to their widespread use.
2. Medications.Approximately 14% of drug-induced dermatitis manifests as urticaria, indicating drugs are a significant cause. Common culprits include penicillin and penicillin derivatives, followed by sulfonamides, tetracyclines, metronidazole, aspirin-based antipyretics, and sedatives/hypnotics. Urticaria can be triggered regardless of administration route—oral, intravenous, or intramuscular.
3. Infections. Various infections, particularly in children, often co-occur with urticaria. Common triggers include suppurative tonsillitis, otitis media, pyoderma, toothache, alveolar abscess, upper respiratory infections, pharyngitis, hepatitis, parasitic diseases, and gastroenteritis.
4. Physical and chemical factors. Exposure to cold, heat, sunlight, pressure, friction, scratching, and moisture often trigger urticaria.
5. Inhaled or contact irritants. Examples include pollen, airborne mold spores, animal dander and feathers, insect bites, and synthetic fiber fabrics.
6. Blood transfusions and blood products. Various antitoxic sera, globulins, albumins, etc.
7. Psychological factors. Examples include excessive stress and insomnia.
8. Genetic predisposition. A small proportion of urticaria cases stem from hereditary factors, often manifesting in infancy or early childhood. Solar urticaria and cholinergic urticaria (microurticaria) are less common in children than adults. However, aquagenic urticaria occurs more frequently in children due to their tendency to play in water.
The impact of childhood urticaria on children should not be underestimated. Let's examine the following points:
1. The course of childhood urticaria varies. Acute urticaria typically lasts less than one month; cases exceeding one month are considered chronic. Most acute cases resolve spontaneously within about one week, leaving temporary hyperpigmentation, though new rashes may continue to appear.Consequently, both old and new lesions may coexist until cooler weather brings gradual resolution, though recurrence often occurs the following year.
2. Urticaria begins with localized skin itching. Scratching causes redness, followed by the rapid appearance of bright red or white wheals of varying shapes and sizes. These intensely itchy lesions emerge in waves, potentially occurring multiple times daily.
3. It may cause gastrointestinal disorders such as nausea, vomiting, diarrhea, and abdominal pain. If left untreated, urticaria can persist for months or even years, with itching worsening upon waking or before sleep, significantly impacting daily life and psychological well-being.