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Purpose of the Review <p>This review synthesizes current evidence on the management of acute and chronic urticaria in pediatric population, providing practical guidance for primary care physicians, allergists, dermatologists, and pediatricians. Therapeutic strategies are analyzed considering recent evidence, with particular attention to similarities and differences compared with adult management.</p> Recent Findings <p>Second generation antihistamines remain the cornerstone of treatment for chronic spontaneous urticaria (CSU). In children over six years, up-dosing up to fourfold is supported by evidence, like adults, though dosing must always account for weight and age. Omalizumab has demonstrated high efficacy (81–90%) in pediatric patients refractory to antihistamines in real-world studies, with a faster onset of response (4–8 weeks) compared to adults. Predictive biomarkers also differ. Elevated total IgE, eosinopenia, and basopenia have been described as relevant factors in treatment response in children, just as in adults. Adapted tools such as the Pediatric UAS7 have improved disease monitoring. Importantly, studies discourage unnecessary dietary restrictions which are implemented in up to 70% of pediatric families, which remain common despite lack of clinical benefit.</p> Summary <p>Management of pediatric urticaria requires a tailored approach that acknowledges unique characteristics such as weight-adjusted dosing, age-specific formulations, and cautious use of third-line therapies. Primary care physicians can effectively manage initial cases, while specialists provide care for more complex presentations. Future perspectives include biomarker-guided personalized therapy, which may improve outcomes and quality of life in children with urticaria.</p>

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Urticaria in Children: Common Points and Differences with Treatment in Adults

  • 期刊论文

  • 发表日期：

    2025年11月5日

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  • Ruth Helena Ramírez Giraldo,
  • Carlos Fernando Chinchilla,
  • Liliana Otilia Taramuel Taramuel,
  • Fardy Mauricio Moreno Oviedo

摘要

Purpose of the Review

This review synthesizes current evidence on the management of acute and chronic urticaria in pediatric population, providing practical guidance for primary care physicians, allergists, dermatologists, and pediatricians. Therapeutic strategies are analyzed considering recent evidence, with particular attention to similarities and differences compared with adult management.

Recent Findings

Second generation antihistamines remain the cornerstone of treatment for chronic spontaneous urticaria (CSU). In children over six years, up-dosing up to fourfold is supported by evidence, like adults, though dosing must always account for weight and age. Omalizumab has demonstrated high efficacy (81–90%) in pediatric patients refractory to antihistamines in real-world studies, with a faster onset of response (4–8 weeks) compared to adults. Predictive biomarkers also differ. Elevated total IgE, eosinopenia, and basopenia have been described as relevant factors in treatment response in children, just as in adults. Adapted tools such as the Pediatric UAS7 have improved disease monitoring. Importantly, studies discourage unnecessary dietary restrictions which are implemented in up to 70% of pediatric families, which remain common despite lack of clinical benefit.

Summary

Management of pediatric urticaria requires a tailored approach that acknowledges unique characteristics such as weight-adjusted dosing, age-specific formulations, and cautious use of third-line therapies. Primary care physicians can effectively manage initial cases, while specialists provide care for more complex presentations. Future perspectives include biomarker-guided personalized therapy, which may improve outcomes and quality of life in children with urticaria.