Hand eczema in children referred for patch testing: North American Contact Dermatitis Group Data, 2000–2016*

Abstract

Learning & Change and has consulted for Henkel. J.S.T. owns noncontrolling shares of stock in AstraZeneca, Cigna, Merck, Johnson & Johnson and Opko Health. He has consulted for Kao Brands and Monsanto (Bayer), is a member of the Cosmetic Ingredient Review Steering Committee, and has a nondependent child employed by Pfizer. E.M.W. has received an investigator-initiated grant from and served as a consultant for Wen by Chaz Dean. She has also served as a consultant for Noven Pharmaceuticals. D.S. receives royalties SummaryBackground Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE). Objectives To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing. Methods A retrospective analysis (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) of North American Contact Dermatitis Group data was performed. Results Of 1634 paediatric patients, 237 (14Á5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49Á4%), atopic dermatitis (37Á1%) and irritant contact dermatitis (16Á9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56Á1% vs. 61Á7%; v 2 -test, P = 0Á11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. The allergens with the highest mean significance-prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone.

Atopic Dermatitis: Evolution and Revolution in Therapy

“…Chronic hand eczema (CHE), which has considerable overlap with AD in many patients, especially children and adolescents, [22][23][24] is another area of interesting research. This high-prevalence condition is associated with allergic and irritant contact dermatitis [24][25][26] -conditions that are both considered alternative diagnoses for and exacerbators of AD 27 -and is a disease process currently being targeted for new therapies. Delgocitinib (NCT04872101, NCT04871711), the novel JAK inhibitor ARQ-252 (NCT04378569), among other topical agents, as well as systemic therapeutics such as gusacitinib (NCT03728504), are in active trials for CHE.…”

Hand eczema in young people: atopic dermatitis and beyond

“…One crucial step in the diagnostic workup is patch testing, which is the approach taken by Silverberg et al, in their article in this issue. 3 In a study population of over 1600 paediatric patients (age < 18 years), 237 patients (14Á5%) were identified as having hand eczema. Almost 50% of these patients had the ACD subtype, 37% had the AHE subtype and (only) 17% had the irritant subtype (of which more than two-thirds of cases were work related).…”

“…5 Hand dermatitis was significantly increased (27%) in adolescents (compared with 14Á5%). 3 Children and adolescents showed significantly lower reaction rates to fragrance mix, methyldibromo glutaronitrile, methylisothiazolinone and propolis (which can be considered 'cosmetic-related' allergens). Positive reactions to mercapto mix among children and to cobalt among adolescents were significantly more frequent.…”

“…The main subdiagnoses are ICD, ACD and AHE. One crucial step in the diagnostic workup is patch testing, which is the approach taken by Silverberg et al , in their article in this issue 3 . In a study population of over 1600 paediatric patients (age < 18 years), 237 patients (14·5%) were identified as having hand eczema.…”

“…IVDK patch test data from 591 children (aged 6–12 years), 2451 adolescents (aged 13–18 years) and 12 122 adults acting as controls (aged 60–66 years), covering the period 2009–2016, were analysed 5 . Hand dermatitis was significantly increased (27%) in adolescents (compared with 14·5%) 3 . Children and adolescents showed significantly lower reaction rates to fragrance mix, methyldibromo glutaronitrile, methylisothiazolinone and propolis (which can be considered ‘cosmetic‐related’ allergens).…”