Chronic urticaria in children

Chronic urticaria is a type of urticaria, and is also a skin disease with a long course and slow onset. Chronic urticaria is generally caused by allergies, so the incidence of chronic urticaria is relatively high for children with poor resistance. In order to alleviate the pain caused by this disease, timely treatment is necessary. Below, I will introduce the treatment methods of chronic urticaria in detail.

1. Find the cause

Ask about the medical history in detail, strive to find out the cause of each patient's illness, whether there is a family history of the disease, whether there is a history of acute or chronic infection, medication history, occupation, lifestyle habits and environmental changes, etc. Check blood, urine and stool routinely, and perform skin allergen test, ice test, acetylcholine skin test, serum IgE test and serum complement test as needed. Some patients need to undergo tests for HBV-DNA, thyroid antibodies, malignant tumors, etc.

2. Avoid triggering factors

For cold urticaria, pay attention to keeping warm; for acetylcholine urticaria, reduce exercise, sweating and mood swings; for contact urticaria, reduce the chance of contact, etc.

3. Use antihistamines

Most patients can achieve satisfactory results after treatment with antihistamines, but a few patients are more stubborn. For stubborn and intractable urticaria, the dosage can be increased or combined medication can be used. H1 receptor antagonists have strong anti-histamine and anti-other inflammatory mediator effects and are effective in treating all types of urticaria. Commonly used H1 receptor antagonists include diphenhydramine, cyproheptadine, chlorpheniramine, acrivastine, cetirizine, mizolastine, loratadine, ebastine, azelastine and desloratadine.

4. Choose drugs that inhibit mast cell degranulation

Ketotifen inhibits mast cell degranulation and prevents the release of inflammatory mediators by increasing the concentration of cAMP in the body. Its inhibitory effect is stronger and faster than that of sodium cromoglycate and it can be taken orally. Tranilast reduces histamine release by stabilizing mast cell membranes.

5. Glucocorticoids

It has strong anti-inflammatory and anti-allergic effects. It can stabilize mast cell membranes and lysosomal membranes, inhibit the release of inflammatory mediators and lysosomal enzymes; constrict blood vessels and reduce exudation. It has good effect on urticaria, especially suitable for acute urticaria, serum sickness urticaria, pressure urticaria and autoimmune urticaria. Commonly used drugs include prednisone and Diprosone. In emergency situations, use hydrocortisone, dexamethasone, or methylprednisolone intravenously.

6. Immunosuppressants

When patients with chronic urticaria have an autoimmune basis, the disease recurs, and the above treatments are ineffective, immunosuppressants can be used. Cyclosporine has a good therapeutic effect. Azathioprine, cyclophosphamide, methotrexate and immunoglobulin can all be tried. Tripterygium wilfordii also has a certain therapeutic effect.