Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Abstract

Aims: The results of patch testing in children visiting our out-patient clinic with suspected allergic contact dermatitis (ACD) were prospectively investigated and compared with those reported in the literature. A review of the literature on patch testing and ACD in children is provided. Methods: Children were patch tested using the TRUE® test, supplemented with tixocortol-17-pivalate, budesonide and 3 commonly used emollients. Supplementary patch tests were undertaken on indication. Results: Seventy-nine children (31 boys and 48 girls) were patch tested. Of the patients tested, 40 (51%) had 1 or more positive allergic patch test reactions. Twenty-two (55%) of these 40 children suffered from atopic dermatitis, 9 (23%) from hand or foot dermatitis, and 9 (23%) from other skin ailments. Nickel was the most common contact allergen, but many other common and less common allergens were noted to give positive patch tests in patients. Conclusion: Sensitization to contact allergens may begin in infancy and continue to be more common in toddlers and young children. In recalcitrant atopic dermatitis, especially at the age of 5 years and over, patch tests are indicated. Good information on preventing the development of ACD in children is useful for caregivers.

The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis

“…In studies conducted with children with AD, the frequency of thimerosal sensitization was reported as between 1.5% and 12.2% in the patch-tested population (10,17,30). In our study, the thimerosal sensitization rate was 5.2% (7/134).…”

Allergic Contact Dermatitis in Children

“…Sensitization to contact allergens begins in infancy and continues to be more common in toddlers and young children (Seidenari et al, 1992;Giordano-Labadie et al, 1999;Vozmediano & Hita, 2005;Militello et al, 2006;Clayton et al, 2006;Garg et al, 2009;De Waard-van der Spek & Oranje, 2009), the age of sensitization can occur very early. In study of Bruckner et al (Bruckner et al, 2000), 45% of patients with positive reactions were younger than 18 months.…”

“…De Waard-van der Spek and Oranje (De Waard-van der Spek & Oranje, 2009) found 3 children patch tested positive to sorbitan sesquioleate (SSO), all clinically relevant. Two children used emollient contained SSO as emulsifier.…”

Kontaktallergie und Atopie

“…In der Epikutantestung (Inhaltsstoffe der topi schen ADTherapie) reagierten 6% der Kinder positiv. In einer deutlich kleine ren prospektiven Untersuchung aus den Niederlanden fand sich sogar bei 47% der Kinder mit einer AD (mittleres Al ter 10 Jahre) eine positive Epikutantestre aktion [10]. Anhand dieser beiden Stu dien ist exemplarisch gut ersichtlich, dass eine Vergleichbarkeit der Prävalenzdaten in Anbetracht unterschiedlich großer Pa tientenkollektive und verschiedener getes teter Testreihen erschwert ist.…”