Acute urticaria in children: course of the disease, features of skin microbiome

Introduction
Quantitative and qualitative changes in the microbiome of the skin affect the emergence and course of allergic diseases, in particular, of acute urticaria.

Aim
To investigate the taxonomic composition of the skin microbiota in children with acute urticaria and to study its effect on the course of the disease.

Material and methods
In total, 75 children with diagnosed acute urticaria at the age of 7–-14 years were examined. The average age of children was 10.83 ±0.95, of which 44 (58.7%) were boys, and 31 (41.3%) were girls. The control group consisted of 30 virtually healthy children of the appropriate age, of whom 16 (53.3%) were boys, and 13 (46.7%) were girls.

Results
Regardless of the severity of the disease, the examined children suffering from acute urticaria had sensitization in history with a significant prevalence of food sensitization (p < 0.05). The occurrence of a severe episode of acute urticaria is associated with allergens of drug origin in 52.6% of cases and the action of unidentified triggers in 47.4% of cases. In children with acute urticaria, S. epidermidis, S. aureus, bacteria of the genus Peptococcus, and Peptostreptococcus dominated on a non-affected skin area, while for the affected skin area, the Propionibacterium, S. aureus, S. epidermidis, bacteria of the genus Peptococcus, Propionibacterium, and Peptostreptococcus were denoted as dominating.

Conclusions
High frequency of S. aureus detection on affected and non- affected skin areas in children with acute urticaria is a predictor of the disease severity.