Children with Atopic Dermatitis Should Always be Patch-tested if They Have Hand or Foot Dermatitis

Abstract

Atopic dermatitis is the most common chronic inflammatory disease among children in industrialised countries. Many factors influence this disease in a negative way and contact allergy is one such factor. The aim of the study was to examine the frequency of contact allergy among children with the diagnosis atopic dermatitis. Contact allergy was found in 22/82 children (26.8%), the most common from Amerchol L101 (11.0%), potassium dichromate (7.3%), and nickel sulfate (4.9%). A statistically significant difference in contact allergy frequency was demonstrated for those with hand and/or foot eczema compared to those without. Children with atopic dermatitis who suffer from hand and/or foot dermatitis should always be patch-tested to evaluate whether they have a relevant contact allergy and thus allergic contact dermatitis.

Factors associated with combined hand and foot eczema

“…Foot eczema has been reported to be associated with filaggrin mutations; however, the increased prevalence was found in patients with atopic dermatitis only . Children with atopic dermatitis affecting hand and/or feet have been shown to have an increased prevalence of contact allergy as compared to children with atopic dermatitis but without hand or foot eczema …”

Belt Buckles—Increasing Awareness of Nickel Exposure in Children: A Case Report

“…8,9 This fact advances the importance of contact allergy testing in children with recalcitrant or widespread severe AD, because such situations may indicate the presence of underlying or superimposed ACD. 10 Additionally, recognizing the risks of Ni-ACD associated with piercing may justify preemptive avoidance of nickel among patients with AD, to decrease sensitization and morbidity.…”

Contact hypersensitivity to nickel in patients with atopic dermatitis

“…Najczęstszymi alergenami były metale, głównie nikiel, rzadziej substancje zapachowe [39] i podłoża leków stosowanych miejscowo [40]. Wyprysk kontaktowy alergiczny, prowokowany głównie przez substancje zapachowe, chrom, nikiel i lanolinę, obserwowano u 14,9-64,2% dzieci chorych na AD [41][42][43][44]. Zjawisko to częściej stwierdzano u dzieci z wypryskiem rąk i/lub stóp (43,8%) niż bez tego objawu (16,0%) [43].…”

“…Metals (especially nickel) and to a lesser extent flavorings [39] and bases of locally administered drugs were the most common allergens [40]. Allergic contact dermatitis provoked mainly by flavorings, chromium, nickel and lanolin was reported in 14.9-64.2% of the investigated pediatric population with AD [41][42][43][44]. This phenomenon was more widespread in children with hand and/ or feet eczema (43.8%) than without this symptom (16.0%) [43].…”