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Abstract: This is a case of a 14-month-old male child with large flat bumps on the thighs and trunk starting 3 days ago, which appeared and disappeared rapidly. After treatment with anti-allergy and anti-pruritic drugs, the skin surface changes disappeared and the symptoms recovered.
Basic information】Male, 14 months
Disease Type】Acute urticaria
Hospital】Harbin Hospital of Traditional Chinese Medicine
Date of consultation】April 2022
Treatment plan】Medication (Cetirizine Hydrochloride Drops+Glutamate Lotion)
【Treatment Period】Home treatment for 10 days, call back after 10 days
Effectiveness of treatment】No more wind-like changes on the skin surface, itching disappeared
I. Initial consultation
The parents brought a 14-month-old child to the clinic, stating that the child had started to have flaky raised bumps on the skin surface 2 days ago, with a clear tendency to scratch, and accompanied by crying. However, the bumps quickly faded within a few hours and did not leave any traces after fading. On examination, the skin surface of the child’s outer thighs showed a patchy, flesh-colored, and clearly raised bumps to the touch. After asking the parents about the child’s diet, the parents said that the child had developed this clinical manifestation after eating mangoes 2 days ago, and considered acute urticaria based on the overall situation. After communicating with the parents, the child was advised to have a routine blood test, and the eosinophils were clearly seen to be rising in the routine blood test.
II. Treatment history
The child’s quality of life was significantly affected because of the obvious itching that accompanied the skin surface, which had been showing the symptoms for 2 days. We explained the onset, development, symptoms and prognosis of the disease to the parents, and explained the treatment plan. We instructed the child to take oral cetirizine hydrochloride drops, which is an antihistamine that reduces the level of histamine in the nerves and relieves the allergic symptoms. At the same time, topical application of glyburide lotion was applied to the surface of the skin at the onset of the wind-like symptoms. It can improve the quality of life of the affected child by astringent, drying and anti-itching effects, so that the wind-bloc-like changes subside as soon as possible and relieve the itching. Parents are also informed that the disease appears and fades quickly, and although the symptoms may disappear quickly, it does not mean that the disease is completely cured. The treatment cycle of these drugs is 10 days, and it is important to adhere to the full course of medication to avoid recurrence of the disease.
Third, the effect of treatment
After the child returned home, a telephone call was made to the child. The parents described that the number of wind-like changes on the child’s body decreased significantly on the second day after the medication was administered, and the degree of itching also decreased, and the child no longer scratched frequently. After 10 days, the child stopped taking the medication and the acute urticaria did not recur.
IV. Notes
We are glad that the child’s condition has improved as described by his parents. At the same time, the parents of the child were also instructed to pay attention to the diet during home treatment and not to give the child allergy-prone foods, such as fish, shrimp, crab, mango, pineapple and other protease-rich foods, to avoid aggravating the existing allergy symptoms. And temporarily do not eat eggs, milk and other foods rich in animal protein content is relatively high, for soy products and other foods high in plant protein content should also be used carefully to prevent the recurrence of acute urticaria.
It is recommended to take a bath with warm water to avoid contact with hot water that can lead to the recurrence of acute urticaria. It is common for symptoms to recur in the first 2-3 days, so there is no need to worry.
V. Personal insight
Acute urticaria is usually cured within 6 weeks from the discovery of symptoms and is accompanied by intense itching stinging and pins and needles sensation. Younger people are prone to allergies and thus acute urticaria, as in the case of this child, so parents should pay more attention when feeding. Usually it can be caused by cold, heat, sunlight, diet, etc. or recurrence, so treatment should be done to minimize external stimuli and prevent aggravation of existing symptoms.
Acute urticaria can be triggered by factors other than food, but also by penicillin, sulfonamides, or certain vaccines, so when similar symptoms occur, it is important to consider the triggering factors from multiple perspectives. If the symptoms are severe, it is recommended to seek medical attention for appropriate treatment.