B) Acute urticaria is defined as lasting < 6 weeks
Infections, foods, medications, and insect stings are common triggers for urticaria. In many studies, infections are the most common trigger. Many times, even a thorough history cannot a definite trigger. Individual urticarial lesions typically last ~24 hours then fade, but patients can continue to break out with new lesions, particularly if they are still being exposed to the trigger. Therefore, initiating a few days of anti-histamine therapy is indicated even if there are no lesions at the time of presentation to the ED (as long as the diagnosis is clear, e.g from reviewing photos). Second generation non-sedating anti-histamines such as cetirizine or loratadine are preferred for first-line therapy. A sedating first generation anti-histamine such as diphenhydramine or hydroxyzine can be dosed at night if itchiness is keeping the child awake. Sometimes in prolonged acute courses, a trial of a corticosteroid burst (e.g. 5 days of prednisone) may be used. Although rare, urticaria can occur in neonates and young infants.
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May 21, 2024 at 11:09 pm
B) Acute urticaria is defined as lasting < 6 weeks
Infections, foods, medications, and insect stings are common triggers for urticaria. In many studies, infections are the most common trigger. Many times, even a thorough history cannot a definite trigger. Individual urticarial lesions typically last ~24 hours then fade, but patients can continue to break out with new lesions, particularly if they are still being exposed to the trigger. Therefore, initiating a few days of anti-histamine therapy is indicated even if there are no lesions at the time of presentation to the ED (as long as the diagnosis is clear, e.g from reviewing photos). Second generation non-sedating anti-histamines such as cetirizine or loratadine are preferred for first-line therapy. A sedating first generation anti-histamine such as diphenhydramine or hydroxyzine can be dosed at night if itchiness is keeping the child awake. Sometimes in prolonged acute courses, a trial of a corticosteroid burst (e.g. 5 days of prednisone) may be used. Although rare, urticaria can occur in neonates and young infants.