This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
We sought to determine if the COVID-19 pandemic was associated with changes in Kawasaki disease (KD) phenotype and cardiac manifestations. Patients hospitalized with acute KD and enrolled into the International KD Registry were categorized into time periods based on admission date: during the pandemic (January 1, 2020 – September 30, 2022, 33 months) and after the pandemic (October 1, 2022 – September 30, 2025, 36 months). Only patients with verified KD diagnoses as per American Heart Association criteria with no evidence of preceding COVID-19 exposure were included. Demographics, clinical features, management, and cardiac manifestations were compared between time periods. From across 45 sites, 726 during pandemic and 813 after pandemic KD patients were included. During pandemic patients were younger (median 2.6 vs. 3.3 years; p < 0.001), more commonly had incomplete KD (15 vs. 9
Background. Parry-Romberg syndrome (PRS) is a rare disorder characterized by hemifacial, unilateral, progressive loss of adipose tissue, muscles, cartilage, and bone structures. It is a variant of linear morphea, an autoimmune disease in which sclerosis with diffuse thickening and induration of the skin. Methodology. Longitudinal, ambispective, observational, descriptive study of patients aged 0 to 18 years with diagnosis of PRS treated at the Instituto Nacional de Pediatría from 2020 to 2025. Descriptive statistics were used to analyze the variables. Results. We included 8 patients, 4 were female. 4 had right face involvement. The mean age at presentation was 4.5 ±2 years, at diagnosis 8 ±2.9 years. The most frequent superficial clinical findings were hyper/hypopigmentation (8), dermal (8), and epidermal atrophy (5). Deep involvement included subcutaneous tissue atrophy (8), facial asymmetry (8), and bone atrophy (6). All had associated abnormalities: maxillofacial (7), ophthalmological (6), and neurological (2). All patients received ≥2 systemic immunosuppressants and 4 underwent facial lipostructure. Conclusions. In this study, manifestations of PRS initiated in preschool age and diagnosis was delayed 3.5 years. Hyper/hypopigmentation, dermal and subcutaneous tissue, and facial asymmetry were present in all patients. All patients received systemic immunosuppressive treatment and 4 also had corrective procedures, recommended when the disease has been inactive for ≥1 year.
Objective: The objective of the study is to describe the clinical, epidemiological, and genetic profile of patients with Duchenne muscular dystrophy (DMD) treated at a tertiary care pediatric hospital in Mexico. Methods: This was a retrospective, observational study of 74 patients with genetically or biopsy-confirmed DMD who were evaluated by Pediatric Neurology between 2010 and 2022. Clinical, demographic, biochemical, genetic, and therapeutic data were analyzed using descriptive statistics. Results: All patients were male. The median age of symptom onset was 3 years, with a median age at diagnosis of 7 years. At the initial evaluation, 87% were in the ambulatory stage. Gastrocnemius hypertrophy (94.5%) and Gowers’ sign (87.8%) were common findings. Deletions in exons 45-55 of the DMD gene were identified in 74% of molecularly confirmed cases. Steroid therapy was administered to 81% of patients, mostly deflazacort. Neuropsychiatric (41.9%), orthopedic (44.5%), and respiratory (44.6%) comorbidities were frequently observed. Only 6.7% were candidates for gene therapy. The mean age at loss of ambulation was 10.2 years; one death due to respiratory failure was recorded. Conclusions: Despite advances in diagnostic and therapeutic strategies, patients with DMD in this setting continue to have poor outcomes, likely due to low clinical suspicion leading to delayed diagnosis and treatment. Early detection protocols, measurement of creatine kinase in children with motor delays, and multidisciplinary management are crucial to improving outcomes and survival.
