Parents often encounter urticaria in a child: urticaria, or urticaria, is widespread in childhood. Allergy is most often manifested in this way. The task of parents is to be able to distinguish urticaria from other dermatological diseases and from viral infections in order to help the child correctly.
About pathology
Hives, or nettle fever, was named so for the outward resemblance of skin rashes with nettle burns. In fact, the disease is dermatitis, in 99% of cases it is allergic. Blisters on the skin form rapidly, quickly, they itch, have a raised shape, pale pink color, which makes them very similar to traces of contact with nettles.
The prevalence of urticaria is extremely wide - according to some reports, up to a quarter of the entire earth's population at least once encountered this form of dermatitis. Children and women are more often affected by the disease. According to the WHO, the proportion of children with urticaria among all allergy sufferers is at least 15%, while dermatitis resembling nettle burns most often occurs at the age of 2-3 years, 5-6 years. After 7 years, urticaria is much less common, and after 9-10 years it often disappears altogether. If contact with the allergen is constant, the threat is not eliminated, then the urticaria becomes chronic.
There is a somewhat derogatory opinion among the people about urticaria - for some reason it is not considered a serious pathology. But in vain. Statistics available to the Ministry of Health of the Russian Federation indicate that in 40% of cases the appearance of urticaria on the skin is complicated by angioedema (Quincke's edema), in which swelling of the larynx rapidly develops, the child may begin to suffocate.
When closing the glottis, a lethal outcome is not excluded if assistance was provided out of time.
Kinds
Urticaria in children can be acute or chronic. The first is more common. After all, any reasonable and caring parent, after the child is covered with a rash, will begin to look for the source of the allergen, will try to limit contact with him. If this is not done, sensitization will become chronic. In this case, the rash will get worse from time to time.
Urticaria is common and artificial. In the first case, it occurs as a manifestation of an allergy, in the second it is a reaction of the skin to a mechanical effect (if the child is held over the skin with something sharp, for example, a fingernail, he will have a swollen convex strip on the skin). This phenomenon in medicine is also called urticarial dermographism.
Urticaria is a rather broad concept. It includes several types, which are mainly divided due to the appearance of a rash:
- dermographic;
- caused by pressure;
- cold (reaction to cold);
- vibration;
- cholinergic;
- contact;
- aquagenic.
This disease is traditionally referred to, but at a stretch, mastocytosis (urticaria pigmentosa), urticarial vasculitis and chronic genetically inherited cold urticaria. Also, the appearance of a rash on a nervous basis is possible.
When asked whether such a rash is contagious for others, the answer is unequivocal: it is an allergy that does not pose a danger to other people, it is an individual immune response to a certain irritant, which is relevant in this case for a particular child.
Why and how is it developing?
The characteristic rash, similar to a nettle burn, appears as a consequence of the accumulation of histamine, which is formed and deposited in the mast cells of mast cells. The next collision with the antigen forces the mast cells to release histamine and release it into the blood. This is how blisters form. Each organism is capable of sensitizing at one rate or another, one person needs more time for this, another less. Therefore, a nettle rash appears both at the first contact with a hazardous substance, and with repeated contact, in which case histamine accumulates gradually.
The capillaries become more vulnerable, their walls become more fragile, permeable, the intracellular fluid enters the outer layers of the skin. This is how a rash appears. And it is with these processes in mind that urticaria is considered not a separate symptom, as many think, but an independent disease.
The causes of occurrence can be very diverse. Most often in childhood, food urticaria appears when the rash is caused by a food allergen, insect bites. The characteristic urticaria skin fever can occur with blood transfusions and as a reaction to the vaccine used for the vaccination. Medicines are considered one of the most likely factors in the development of urticaria. So the child's skin can react to household chemicals, chlorine contained in water.
There are children who react with urticarial rash to cold or overheating, to sunlight, vibration or mechanical friction (clothing, diaper, etc.).
In 30% of cases, the true cause of urticaria in a child cannot be identified.
Many parents think that children with intestinal parasites are more prone to hives. We hasten to reassure you: studies have not confirmed any significant role of helminthic invasions in the development of urticaria in babies. And therefore, the appointment of drugs against parasites just like that, just in case, common not so long ago, today is considered unreasonable and incorrect.
Symptoms and Signs
Nettle fever in children always appears suddenly. Not one blister, not two. The rash is numerous at once, rather extensive, the blisters have a rich pinkish color. It is noteworthy that most of the rashes at the initial stage appear exactly during the first 60 minutes after contact with an allergen, while the content of histamine in the blood is significant. Everything that will happen in an hour is no longer so significant - if new blisters appear, then in extremely small quantities.
This is the main difference between urticaria and any infectious disease. And all that parents need to remember is the time of the spread of rashes: if there are a lot at once, we are talking about urticaria, if one or two blisters and gradually, then an infection should be suspected, for example, chickenpox.
Another characteristic feature of urticaria is the speed of disappearance. As soon as the amount of histamine in the blood begins to fall, the rash will begin to fade and disappear without a trace. This usually happens within a few hours. But there are options in which a "second wave" can start: as soon as the first rash passes quickly, a new one appears, just as extensive, possibly in a different place.
If the form of the disease is chronic, such "waves" will replace each other with an enviable frequency and symptoms can be observed for several months.
Classic urticaria is quite painful. The elements of the rash itch, itch, give the child unpleasant sensations when touched, the skin around each blister is somewhat swollen, due to this, the elements merge into large skin manifestations. The child's condition depends on how extensive such formations are: if the urticaria appears only on the priest or only on the hands, on the palms, for example, from contact with household chemicals, then the general condition is unlikely to suffer. If the rash is in the groin, on the face, this is a more painful condition. And if there are extensive foci of a rash on the body, legs, back and abdomen, the condition can be significantly impaired.
Most often, a deterioration in well-being occurs due to subfebrile temperature, which occurs as a protective reaction to the release of histamine into the blood. A small child may experience a disorder of appetite, stool, sleep, moodiness, crying. An older child complains of headache and malaise.
Each form of urticaria can have its own distinctive features in manifestations.
Chronic
With chronic urticaria, the child often has concomitant problems with the state of the gastrointestinal tract, there are problems with the liver. The focus of a chronic infection may lie in the tonsils or gallbladder, as well as in the mouth if the baby has advanced caries. In this case, autointoxication occurs. When a rash appears, they talk about an exacerbation, and often, especially in young children, during an exacerbation, there is increased nervousness and emotional instability, headaches, nausea and even vomiting, disturbance of stool, sleep. Sometimes an attack of chronic urticaria can lead to swelling of the meninges.
Infant
The urticaria, which occurs in infants, is called the stropulus by doctors. It is always associated with nutrition - against the background of food allergic sensitization of the baby's body. Most often, children who are prone to diathesis with the formation of weeping ulcers and eczema are susceptible to such nettle fever.
Those children who eat adapted formulas or those who are not fed according to their age most often develop a rash in the form of nodules. Also, infant urticaria can be associated with insect bites (mosquitoes, flies). The size of the blisters is small - about 3 millimeters, there is a small bubble at the top. Itching can lead to the fact that the child begins to scratch the formation, which is dangerous due to bacterial complications.
In infants, urticaria most often affects the skin in large folds, but an extensive rash spread throughout the body is also possible. Additionally, babies almost always have stool disturbances (diarrhea or, conversely, difficult defecation), as well as impaired appetite and sleep, they become more lethargic.
Giant
A synonym for this urticaria - Quincke's edema. Pathology is manifested not only by a sudden rash, but also by the same sudden edema of the subcutaneous tissue, muscle tissue. The most dangerous is swelling in the larynx, as it can lead to asphyxiation.
Edema is always located in the direction of the muscles. They can last for several days, after which they subside. If swelling of the larynx occurs, the child begins to breathe with difficulty, his lips turn blue. You need to act immediately: call an ambulance, take the child out into the fresh air or open all the vents and doors to the street at home to ensure the flow of oxygen, if necessary, give one age-related dose of an antihistamine that the baby has already used. A child in such a state needs urgent hospitalization.
Cold
This form of the disease manifests itself in children, especially sensitive to cold, sunlight. Characteristic rashes appear after exposure to an appropriate factor. A child with individual sensitivity, if his hands are frozen on the street, blisters will appear on his hands. Sun allergy usually affects children with fair skin, blond hair, and blue eyes.
A rash can also appear with a sharp temperature drop (from the summer heat, the child was brought into a room with an air conditioner, or from the cold they were brought into a hotly heated bath). This form of nettle fever may well appear not immediately, but after a few hours and even a day after the temperature fluctuations.
Other forms
It is worth noting the toxic form of urticaria - an instant and urgent reaction to contact with certain chemicals, with some plants and animals. Here it is important to determine which substance the child has an inadequate reaction to in order to exclude contacts. This does not mean that a person with a cat intolerance in childhood will never be able to get a cat: as already mentioned, children tend to "outgrow" their allergies, only 3% of allergy sufferers retain their immune response in adulthood. The rest get rid of allergies without a trace and may well eat oranges and pet kittens, feed aquarium fish and do everything that they could not afford in childhood.
Diagnostics
An experienced doctor can always recognize urticaria "by sight" but an accurate diagnosis is made only on the basis of laboratory tests. Parents may not always remember what the child ate, drank, or had contact with during the last 24 hours, and therefore allergological tests, which are considered the most accurate method of establishing the fact of body sensitization, can help in the search for an allergen.
Allergy tests will not always give an answer to the question of what exactly the child develops urticaria, because the most common, so-called standardized allergens are taken for them, and a particular baby may have a reaction to another substance that is not included in the list of standardized ones.
The essence of the tests is reduced to the reaction to various allergens. What will be the reaction - he is the "culprit" of nettle fever.
Modern medicine has several types of research that can be prescribed to a baby. Most often, children are recommended an immunological blood test.
For total immunoglobulin E
IgE is determined in the blood if sensitization occurs. In this case, the level of immunoglobulin indicates its extent. Blood is taken from a vein. Parents should know that it is impossible to feed and water the child before such an examination, and if the child, as prescribed by the pediatrician, takes any medications and it is not possible to cancel them, the allergist should also know about this fact before the blood is taken for analysis.
For specific immunoglobulins
Such a blood test is carried out to a child if the fact of an allergy has already been established, but a specific allergen is not. The blood serum of a small patient is mixed with various allergens, for example, with plant pollen, animal saliva, house dust, etc. The reaction makes it possible to judge which group of allergens can cause a negative reaction in a child.
Immunocap
This test is carried out in the event that none of the previous ones could give a clear answer to the question of the origin of the allergy. The study requires more blood, and therefore babies are not prescribed such an analysis. Most often, you can count on the appointment of such a survey only from adolescence.
In addition to blood tests, skin tests may be recommended for a child with hives. Their passage may take time: in one session, the doctor can apply on the skin of a small patient no more than 20 types of allergens, and there are thousands of them. Samples are recommended for children aged 3 years and older. The task of the doctor is to find the substance to which the skin will react positively. Usually, allergen solutions are applied to the forearms, but the procedure can also be performed on the back skin. For babies, drops of solutions are applied to the skin, while teenagers can get a few scratches and drip the solutions there.
Treatment
Since in the development of allergic reactions, modern medicine is still not very clear, then in the treatment of urticaria there are many questions to which there are no answers. So far, the most effective way to treat urticaria is to detect the allergen and limit contact with it.If the immune response is caused by animal hair, doctors recommend getting rid of the animals, if the matter is in pollen, then the child is restricted from breathing it in and touching it. However, even existing allergy tests do not help to identify the allergen in a third of cases, and therefore the treatment of urticaria turns into a large and interesting quest for parents, whose task is to prevent re-sensitization at any cost.
The child may be advised to take antihistamines to relieve symptoms. These drugs include "Suprastin", "Loratadin", "Claritin", "Diazolin" and many other drugs that differ in dosage, active ingredient and age restrictions. A doctor will help you choose a specific remedy. The clinical guidelines of the Ministry of Health clarify that mainly children who have occasional urticaria need treatment. Very often, medicines are not needed in principle, because, as we know, urticaria quickly passes, and it is enough just to exclude the further influence of the allergen on the child's body.
In combination with antihistamines, local remedies can be prescribed - ointment, cream, spray, for example, "Fenistil". Urticaria without itching is rare, and therefore a child may need a local remedy that has a cooling, antipruritic effect, reduces swelling and soothes.
It should be understood that medications do not eliminate allergies, do not cure them, but only relieve some of the unpleasant symptoms.
In all cases, without exception, a hypoallergenic diet is recommended. The child's menu should contain only products with a low degree of potential hazard. Your pediatrician or allergist will provide a list of products. He always excludes the presence of nuts, citrus fruits, foods with food colors, seafood, whole milk on the baby's table.
Additionally, calcium supplementation is recommended if antihistamines are prescribed. And only when none of the listed treatment helps to relieve the baby from the manifestations of nettle fever, hormone therapy, for which corticosteroid hormones are used, can be recommended.
If a child develops a food allergy, it is additionally recommended at home during symptomatic treatment give him sorbents - "Enterosgel", activated carbon, and it is also recommended to drink plenty of water, after all, the main task is to remove the allergenic substance from the body as soon as possible.
If the doctor believes that the child is overly emotionally excitable and suspects a psychosomatic component in his allergy, he may advise the parents to give the baby age-approved herbal sedatives, this will help calm down, relieve excessive excitement of the autonomic nervous system.
During treatment, the child can wash, but only after being examined by a doctor who can differentiate urticaria from scabies, you can walk, because the disease is not contagious. Urticaria does not last long, and with adequate first aid from the parents, after a few hours there is no trace of it, there are no consequences.
In the process of treating urticaria, parents should know which actions are undesirable, erroneous:
- you should not cauterize the elements of the rash with iodine, brilliant green, alcohol;
- you should not give your child antibiotics (his allergy has nothing to do with bacterial diseases, in which you definitely cannot do without antibiotics);
- you cannot cure urticaria with folk remedies, because most of them are based on plant materials, which during the period of illness can aggravate sensitization;
- if the treatment prescribed by the doctor does not help, the rashes appear again and again, the temperature lasts more than three days, a dry, unproductive cough has appeared, the general condition of the child is noticeably worsening, home treatment should be stopped (it is possible that the exposure to the allergen continues) and go to the hospital for hospitalization.
Also, parents are advised to be more careful in the first hour after the development of nettle rashes - if the child began to cough, it is worth calling an "ambulance", it is possible that internal laryngeal edema may develop.
The opinion of Dr. Komarovsky
The well-known pediatrician and TV presenter Yevgeny Komarovsky believes that many manifestations of allergies in a child can be avoided if the space and lifestyle of the child is properly organized. Also, his advice will help moms and dads who are currently dealing with the treatment of an allergic child:
- introduce complementary foods and new foods into the baby's diet gradually, in accordance with the doctor's recommendations, carefully monitor the reaction to each new product (no more than one new dish is introduced per day);
- when treating urticaria, first of all, attention should be paid not to medications that help from this, but to the atmosphere in the house - parents should rid the nursery of everything that can accumulate large amounts of house dust (take out soft toys, hide books in a closet, etc. close with glass doors, carpets and rugs are best removed altogether);
- after an attack of urticaria, it is important to do wet cleaning, evaluate how chemicals are stored (they should be inaccessible to the child);
- the linen of a child with skin allergies should be washed only with a hypoallergenic powder and additionally rinsed (it is better to get rid of the chlorine for rinsing in advance, with which it is saturated at the stations, for this it is enough to boil it);
- a child who is prone to hives should not sweat, so you should not wrap him up excessively;
- clothing and bed linen should be chosen from natural fabrics with a minimum amount of textile dye, ideally white linen and the same T-shirts with panties.
The main thing, Yevgeny Komarovsky thinks, is not to heal the child. Some parents with such zeal rush to treat their child's allergies with medications, which make him a chronic allergic person. Most children, as their immunity develops, "grow" out of allergies.
Prevention
In order to prevent the primary development of the disease, parents should try to exclude possible allergens in the life of a young child. But this does not mean that the baby should not pet cats and sniff flowers. On the contrary, according to recent studies, allergies most often occur in children whom parents try to protect as much as possible from life and its manifestations, while children who grow up from birth in families with cats and dogs walk on the street and have the right to vomit and sniff any flowers, allergies are rather rare.
To prevent allergies, it is important to maintain a healthy immune system. To do this, you do not need to give the child immunomodulators, and from the very birth it is necessary to ensure adequate interaction of the child's immunity with everything that is around, including cats. It is important to temper the baby, not to overfeed him, not to wrap him up so that he sweats, to be attentive to all existing diseases and to treat the child on time.
If a child has already had hives once, it can recur at any time. That is why it is important for parents to take care of the prevention of seizures in advance: if vaccination or local anesthesia is to be taken, antihistamines must be taken first, if the doctor prescribes any medications, it is important to warn him about the child's tendency to nettle fever. The child should lead a healthy lifestyle, preferably with his parents. Smoking in a house where there is a toddler with allergies; you cannot wash the floors there with chlorine-containing detergents.
Wearing loose clothing that will not chafe the skin, lack of interaction with household chemicals will help prevent a possible re-attack.
A hypoallergenic diet is important precisely during the period of exacerbation of allergies, but if there is a state of remission, you can add to the diet in small quantities foods that have an increased allergenic status. It is important to monitor the child's reaction.
And the most important thing: if your child suffers from chronic urticaria, always have a home first-aid kit ready, which can save his life. It should contain antihistamines in tablets or drops, ointment with antipruritic and decongestant effects, as well as a couple of ampoules of Prednisolone and a syringe in case of an acute form of type I allergy, in which the child may suffocate even before the arrival of the ambulance. In this case, the timely intramuscular administration of "Prednisolone" can really save his life. The rest of the help will be provided by the doctors when they arrive to the call.
Reviews
According to the reviews of parents, left on thematic forums, most often in urticaria, suddenness is frightening, in which the mother cannot even approximately imagine what exactly caused such a skin reaction. Many describe that in the course of treatment, the urticaria became paler, then again acquired a rich pink color. Usually she turned pale in the first half of the day, and became brighter in the second.
But in general, the reviews about the treatment are quite positive. The disease passes quickly, and if it comes back, then the parents usually already know well what to do and in what order, to give a drink, than to anoint, so that the unpleasant symptoms recede.
