In general, treatment of UP is conservative and aimed at symptomatic relief.6In some patients, topical corticosteroids may be applied to reduce pruritus and unsightliness of lesions, oral antihistamines may be used to reduce pruritus, and cromolyn sodium therapy may ameliorate gastrointestinal tract symptoms.6Parents and patients should be advised to avoid precipitating causes of mast cell degranulation (insect stings,
sudden changes in temperature, certain medications [alcohol, aspirin,
codeine, morphine, nonsteroidal anti-inflammatory drugs, and others],
certain foods [alcohol, shellfish, some cheeses, spicy foods, and hot beverages], and friction).1,2Although not all patients will see histamine release with all of these triggers, it is helpful to educate families about these precipitating factors. Some patients and their parents worry about the theoretical risk of anaphylaxis in cases of significant mast cell degranulation. Although this is a rare occurrence, an epinephrine autoinjector (EpiPen Jr or EpiPen;
Dey LP, Napa, California) can be prescribed as a precautionary measure.