Changes in Product Use and Quality of Life After Patch Testing in Children With Allergic Contact Dermatitis: A Follow-up Survey

Abstract

Background: Patch testing is the standard to diagnose allergic contact dermatitis (ACD).Objective: This study assessed the value of patch testing for product changes and quality of life in children with ACD. Methods: In this cross-sectional survey, we used a questionnaire to follow up with families of ACD patients about changes since patch testing and counseling preferences. Eligible participants were 18 years or younger during expanded series or personalized patch tests at the Washington University School of Medicine from 2007 to 2020.Results: Of the 43 enrolled participants, most were positive for multiple allergens (63%) and changed personal products after patch testing (71%). Only 26% of the families consistently read product labels before patch testing, compared with 66% after. Patients saw a mean relative reduction of 49% in severity of rash (8.2-4.2 of 10), 46% in interference with activities (5.7-3.1), and 51% in self-consciousness (7.0-3.4) since patch testing. Families gave favorable feedback for counseling on products to avoid (9.4 of 10 average rating of usefulness), product recommendations (8.5 of 10), and chemical names (7.9 of 10).Conclusions: Patch testing can lead to meaningful improvements in quality of life for most children with ACD. Counseling related to positive patch test results should include discussion of specific products to use and avoid.

Need for new strategies to improve the recall and avoidance rates of contact allergens: A retrospective cohort study from Turkey

“…The localisation of eczema was not an influencing factor in remembering the culprit allergens in the present and previous studies 1–12 . However, the severity of dermatitis and impairment in the quality of life at the time of diagnosis positively correlated with the recall rate in some studies 9,10 .…”

“…In a retrospective study, patients with lanolin allergy benefited from detailed information lists, including the products containing the culprit allergen 22 . Recently, increased awareness regarding product labels was observed in families of children with ACD following patch testing 12 . Parents were keen to have detailed information on products to avoid in addition to safe‐to‐use product lists and allergen chemical names 12 .…”

“…The localisation of eczema was not an influencing factor in remembering the culprit allergens in the present and previous studies. [1][2][3][4][5][6][7][8][9][10][11][12] However, the severity of dermatitis and impairment in the quality of life at the time of diagnosis positively correlated with the recall rate in some studies. 9,10 The long duration of eczema prior to patch testing was further speculated to influence the recall of diagnosed allergens negatively.…”

“…22 Recently, increased awareness regarding product labels was observed in families of children with ACD following patch testing. 12 Parents were keen to have detailed information on products to avoid in addition to safe-to-use product lists and allergen chemical names. 12 In our present study, all patients diagnosed with ACD were given an allergy pass.…”

“…Patch testing and evaluating the clinical relevance of positive patch test reactions are essential for diagnosing allergic contact dermatitis (ACD). During the last three decades, studies focused on patients' perspectives regarding patch testing, 1–12 as the real success of patch testing lies in educating patients with an established diagnosis of ACD to avoid the culprit allergen and the patient's ability to understand and remember the test results and act accordingly in daily life 9 . Most studies reported that only a low‐to‐moderate percentage of patients could remember the exact name of the allergen and/or allergen group, influenced by multiple factors such as sex, age, number of years after patch testing and number of the allergens 1,6–8,10,11 .…”