Wheeze in children aged less than five years has many potential causes. Often it is regarded as the first sign of asthma, however, a substantial proportion of young children who wheeze will not go on to develop asthma. In infancy, bronchiolitis is the most likely cause of wheeze. As children get older, episodic viral wheeze becomes more common. Atopic wheeze is most likely in children with risk factors, such as a family history of asthma. By school-age, some of these children with wheeze will be diagnosed with asthma and others will have “grown out” of their symptoms. Therefore, rather than focusing on making a diagnosis when a young child presents with wheeze, it is more important to ensure the child receives appropriate management of their symptoms and that the parents receive education about their child’s treatment and advice about vaccinations, infection prevention and maintaining a smoke-free home

There is a more recent article on this topic, see here: https://bpac.org.nz/2020/wheeze.aspx

This article is now out of date, click here for latest guidance

New evidence is increasingly suggesting that isotretinoin may be best prescribed using a lower daily dose, with the regimen tailored to the individual patient, the severity of their acne and their response to the medicine.