Urticaria in children
Childhood Diseases / / August 12, 2017
Urticaria - a kind of allergy.The name comes from the symptoms of the disease: the patient appears as if out of the thickets of nettles and covered with red itchy blisters.Blisters these, fortunately, disappear quickly, lasted about 6 hours (in rare cases, they are "trapped" up to 36 hours).
Where does urticaria
As with any allergy, rash develops as a result of immediate hypersensitivity, when the body is not adequately responds to certain substances that come from the outside or generated internally (waste products of bacteria).In response, the body begins to release histamine and other substances that cause inflammation.They increase the permeability of the walls of blood vessels (capillaries), which leads to excess flow of liquid from the blood into the surrounding tissue.swelling appears.As the body tries to reduce the concentration of harmful substances.
as urticaria in children begins
starts urticaria in children suddenly, with intense itching of various parts of theskin.Jumps blisters, and not only on the skin, but also on the mucous membranes of the eyes, mouth, gastrointestinal tract.The appearance of rashes are often accompanied by swelling of one or another part of the body: eyes, lips, hands and joints.Edema as blisters are retained from several minutes to several hours, but in exceptional cases, may take up to 2-3 days.
One of the most dangerous option - angioedema (it is called angioedema, or angioedema) when the swell place with loose fiber - lips, eyelids, cheeks and mucosa of the mouth, larynx, tongue, genitals.Especially dangerous swelling of the mucous membrane of the respiratory tract, when breathing is difficult, there is a whistle and paroxysmal cough, nasolabial triangle turns blue when inhaling.The child panics.The situation is not comic, and if the child does not immediately help, the outcome can be fatal.If the gastrointestinal tract become swollen mucous begins transient diarrhea (diarrhea), nausea, persistent vomiting.The defeat of the nervous system (meninges, the inner ear) appear headache, dizziness, nausea and vomiting, lethargy.
If the disease first emerged, it is called acute urticaria . acute form of urticaria may be associated with malaise, headache, body temperature rise to 38-39S, angioedema.There is often a food allergy.If no measures are taken, a month later acute form of urticaria may become chronic.Therefore, if the rash has not passed through a couple of weeks to a strict diet, it is necessary to search causes more thoroughly and has likely using specialist.
acute form often develops as a result of inhalation of certain substances (certain kinds of dust, pollen, etc.)., A direct contact of the skin with certain materials (silk, wool, fur, latex), insect bites, intolerant of any drugs (sulfonamides, penicillin, aspirin and codeine, and - serums, vaccines), blood transfusion.
If the rash is not gone in a month, you can talk about chronic urticaria. This form of the disease becomes a companion of the poor child for many months, years and even decades, and expressed the endless change of deterioration and improvement.When deterioration appears agonizing itching, itchy places mercilessly comb, and when there is a connection of a secondary infection, urticaria blends in chronic dermatitis.Chronic urticaria is the result of prolonged exposure to the allergen.
cause of the disease can be prolonged disruptions to the gastrointestinal tract (dysbiosis, liver disease and biliary tract), chronic tonsillitis, caries, sinusitis and other chronic inflammatory processes, endocrine, autoimmune diseases, viral and parasitic infections (including giardiasis, hepatitis,worm infestation, Helicobacter pillory, thrush), accommodation in a room with poor environment - one of the causes of chronic urticaria are the evaporation of pentachlorophenol (wood preservative).Sometimes the development of chronic urticaria cause functional disorders of the autonomic nervous system or severe stress.
There is also a so-called pseudoallergic reaction related to the fact that the body fell substances that promote the release of inflammatory mediators from the cells.For example, the child ate polplitki chocolate and covered with a rash.When this antibody (immunoglobulin E) does not occur.If the mother is giving the baby chocolate and further, the body of the child will remember this allergen and starts to produce antibodies to fight it.Despite the name, and pseudoallergic and a rash - all symptoms of the same allergy.The end result is the same from them, and the implementation mechanism - different.
go to the doctor
Prescribe and monitor treatment of two doctors: dermatologist and allergist.As with all diseases, suspecting hive in a child , the doctor collects history, clarifies:
- how and when the illness began;
- than has already had and what medications taken;
- what foodstuff;
- Do not commit long trips;
- whether gastrointestinal, autoimmune diseases suffered.
Think about the answers to these questions!Then comes the examination, during which the doctor carefully inspects the skin.This will rule out other skin diseases.It indicates whether the lymph nodes, whether chronic foci of infection increased.Assign and specific research methods: Wasserman;X-ray, allergological and immunological tests.Sometimes it may require tests for infection, ultrasound of the abdomen, urine, blood, etc.
Acute urticaria. This diagnosis is made, if the appearance of itchy blisters is not related to cold, heat and other physical methods and the impact of the disease is not passed in the chronic form (takes less than 6 weeks).To determine how long the individual elements of the rash persist, several newly emerging blisters encircle the handle and the patient's mother asked the baby to note when they disappear.In acute form of the disease blisters preserved no more than days.Laboratory tests include a complete blood count and urinalysis.To exclude food allergy food provocative tests conducted double blind placebo as control.
Chronic urticaria. main purpose of laboratory tests - to identify the cause of the disease.To do this, carry out a complete blood count, erythrocyte sedimentation rate is determined.To eliminate rheumatism, infectious diseases and metabolic disorders have special studies.Depending on the clinical picture is carried immunoelectrophoresis serum and urine, serum studies and antithyroid Antinuclear antibodies and rheumatoid factor cryoglobulins, examined thyroid function and liver.However, in 90% of cases, all of these studies do not reveal the cause of chronic urticaria.In such cases, diagnosed with "chronic urticaria idiomatic."
urticaria treatment in children
Unfortunately, from the hives are no panacea.Therefore, we must find out the cause of the disease that each child can have their own.It is necessary to find and eliminate contact with the allergen, and to identify violations of the internal organs, nervous and endocrine systems, which may be direct or indirect cause of this process.In chronic urticaria for a closer examination, including a detailed history of the disease, blood, urine and feces, and in some cases, X-ray examination.
basis treat hives , which is prescribed by the doctor, - suppression of inflammatory mediators (antihistamines: suprastin, diazolin, Zyrtec, Claritin, Aerius, fenistil, tavegil et al.), As well as a reduction in vascular permeability and increased tone of capillaries (drugscalcium).If the skin itches very much, your doctor may prescribe a variety of drugs with menthol, anestezin.In severe cases, prescribe hormonal creams with corticosteroids.
There are other ways to reduce the itch: Hot itching, rubbing vodka, vinegar, half diluted with water, fresh lemon juice, a bath with a decoction of nettles, or succession, acceptance powder or decoction of licorice root.To remove the swelling and general cleaning of the body shown diuretics and laxatives, sorbents.The positive effect of the application has enterosorbents (laktofiltrum, algisorb, enteros gel, smectite), and - pre- and pribiotikov (Duphalac, bifidumbacterin, Linex, florodofilus).
In severe autoimmune chronic urticaria requires special treatment (plasmapheresis), which should be carried out in specialized centers.Also, do not forget about the classic methods of combating household, pollen, tick, food, drugs, Insect, fungal allergens.Namely - to pay attention to the environment of your apartment (house), replace the feather pillows to cushion a holofayberom, declare war on dust, fungi (mold), insect.
Remove from the children's room from the window sill plants, refrain from buying birds and other animals (including fish).Smoking in the apartment - under the strict prohibition!Wash children's clothing and underwear soap or a special powder, further caress.
Seek immediate medical attention if your child has swollen face and / or neck, there were difficulties in breathing and swallowing;tachycardia (frequent palpitations), dizziness, nausea and abdominal pain, diarrhea, a rash that does not disappear within 5-6 days, increased body temperature.If the swelling extends to the mucous membranes of the respiratory tract (angioedema) and the child becomes difficult to breathe, immediately call "ambulance."Doctor ambulance enters antihistamines, epinephrine, and prednisone.
swelling in the face and neck is further administered intravenously diuretic and corticosteroid.While "emergency" goes, the child should immediately give any antihistamine, which has a home, as well as provide a surface calm shallow breathing, as if forced, which occurs when frightened, airway swelling increases.To do this, you can give valerian to calm the baby, pick him up, talk to him, make him the cold.If the attack was serious and it came to suffocation, the child needs to be hospitalized.
If urticaria is the food base, the baby needs a special hypoallergenic diet.For the full normalization must pass state from 2-3 weeks to a month, after which you can gradually introduce new products (one every 10-14 days).Breastfeeding mothers should follow the same diet as everything they eat, anyway passes into breast milk.If the baby is bottle-fed, he was transferred to the hypo-allergenic, and sometimes - hydrolyzed mixture.Hypoallergenic menu
- Kashi: buckwheat, rice, corn, boiled water or a hypoallergenic formula.
- vegetables and green crops: zucchini, fennel, lettuce, parsley, broccoli, potatoes, pre-soaked in water for at least 2 hours.
- butter: butter and vegetable.
- Meat: rabbit, turkey.
- Soups: cereals, vegetables with meat of the rabbit, turkey.
- Dairy products: cheese, or a children's village;fruit yogurt with no additives.
- Bakery, confectionery bread - unleavened white cookies Hypoallergenic, drying, dry crispbread.
- Sugars: Fructose.
Along with food allergies in children is often a so-called contact urticaria , which occurs upon contact of the skin and mucous membranes with certain substances.The most common - with latex.Manifest blisters and redness, sometimes - itching or burning.In severe cases, especially when exposed to latex possible anaphylactic shock.Therefore, be careful, watch from a composition made nipples on bottles and pacifiers.To contact urticaria can be attributed to a reaction to laundry detergent, shampoo, foam bath.An allergic reaction is a surfactant contained in these vehicles.
Besides food allergy is a lot of varieties of urticaria arising from external physical impact.In these cases, the child's body in response to mechanical stimulation releases inflammatory mediators.Species such allergies few.
Urticaria pressure. rash appears after pressing on the skin:. From prolonged sitting, carrying straps, rubber bands from pantyhose, etc. The rash is accompanied by a burning sensation and usually lasts about 30 minutes (in the case of an immediate response) and 0.5-9 hours (in the case of delayed reaction).The kid complains of malaise, fever and headache.
Dermograficheskaya urticaria (mechanical). name literally translates from Greek as "drawing on the skin."It appears after application to the skin of light scratches, skin scratching.
Vibratory urticaria occurs after exposure to vibration.For example, a child can sprinkle after a trip by car or public transport, after running, massage, etc.The rash appears a few minutes after stimulation.
heat-cold. This kind of urticaria appears in children with extreme sensitivity to heat or cool the skin.
cholinergic urticaria. When the temperature rises there punctulate strongly itchy rash Blistering with a bright red border.For some children, the rash appears after the child run about, others - after exposure to heat (for example, after a hot shower).Often the occurrence of this reaction provoked a hot shower, exercise, and emotional distress.The rash is so characteristic that is typically for the diagnosis the doctor enough of one type of blisters.
heat urticaria. rare disease, which is characterized by large blisters that occur after exposure to heat.The size of the blisters distinguish from cholinergic urticaria heat.Heat rash can be combined with the cold and sun.
Cold urticaria.Called cooled (cold water or cold air).The reaction is typically delayed - for rash appears necessary to skin contact with a cold object or cold air from 5 to 20 minutes.In severe exacerbations are often observed weakness, headache, dizziness, shortness of breath, tachycardia.Occasionally the kids complain of abdominal pain and nausea.After eating cold food available tongue and throat swelling (observed mene than 5% of patients).
Solar urticaria. have children is especially sensitive to this need, it would seem, things like water and sunshine.Solar urticaria - a rare form of the disease, due to the action of ultraviolet radiation.The rash appears on the exposed skin (face, hands, etc.) In a few minutes or hours after sun exposure.Prolonged exposure to the sun possible sharp deterioration: respiratory disorders and cardiac activity, sometimes - shock.
cause of the disease are most often the liver diseases and disorders of porphyrin metabolism.For the diagnosis of doctors use the ultraviolet radiation of different wavelengths.For the treatment of prescribers, reducing sensitivity to light, as well as creams with a high level of protection from ultraviolet rays.
Akvagennaya urticaria. Also, a rare disease in which the rash occurs only after contact with water of any temperature.The rash is the same as in cholinergic urticaria, occurs within minutes after contact with water.