Pediatric urticaria and angioedema

Although urticarial lesions and angioedema are common in children, they fre quently present challenges for the clinician in terms of identifying a caus e and obtaining effective relief. The wide range of triggers implicated in urticaria and angioedema requires a thorough history and occasionally speci fic testing to confirm or exclude a specific disorder. Although the underst anding of the pathophysiology and mediators involved in urticaria is advanc ing, treatment with antihistamines remains the first-line therapy. The deve lopment of second-generation antihistamines is promising treatment for chil dren, whereas other medications are yet to be systematically studied in thi s age group. The optimal therapeutic regimen may require not only trials of various medications guided by the clinical response and acceptable Side ef fects, but also empathy, explanations, and reasonable expectations.