Chronic urticaria in childhood

Abstract

Chronic urticaria (CU) is characterised by recurrence of hives or angioedema almost daily for at least 6 weeks. It is benign, but can be intractable, and hence, frustrating for patients and physicians alike. Diagnosis is clinical and based primarily on an allergy-focused history and physical examination. Routine referral for allergy testing is not always required. The goal of treatment is symptomatic relief with non-sedating antihistamines. Targeted screening for nutritional deficiency is of proven benefit. Triggers of CU in childhood are varied and different from CU in adults. This article aims to update GPs on CU in children, focusing on management in primary care, guidance on specialist referral and details of the subsequent targeted diagnostic pathway with non-invasive testing undertaken by paediatricians.