Systemic Contact Dermatitis in Children: How an Avoidance Diet Can Make a Difference

Abstract

Systemic contact dermatitis is an under-recognized skin reaction that occurs secondary to systemic (oral, intravenous, intramuscular, inhaled, or subcutaneous) exposure to a hapten in a previously sensitized individual. Medicaments are the most common cause of SCD in the adult population, but other chemicals like nickel, cobalt, balsam of Peru, and formaldehyde have been implicated as well. Few reports in children exist to date. Dietary restriction has shown to be of some benefit in managing some adult patients. We present a case series of 8 pediatric patients diagnosed with SCD from the contact dermatology clinic, who showed marked improvement of their dermatitis after adequate dietary avoidance. We review common presentations of chemicals causing SCD in children and potential dietary modifications.

The effect of different substrates on the growth of six cultivated mushroom species and composition of macro and trace elements in their fruiting bodies

“…It is thus necessary to underline that cultivation of this species should ensure that employed substrates are low in Ni content. Food containing increased Ni levels is known to induce systemic contact dermatitis [57]. Importantly, a recent screening study of C. maxima available in trade found that it does not contain Ni levels of any concern to human health [42].…”

Myroxylon pereiraeresin (balsam of Peru) – A critical review of the literature and assessment of the significance of positive patch test reactions and the usefulness of restrictive diets

“…2 Later, in a number of patients sensitized to MP, dermatitis was found to resolve or improve after they had followed an MP-restrictive diet. 105,106,[108][109][110] Oral administration of MP (provocation test) sometimes resulted in exacerbation of dermatitis. 104,105,110 Various studies on oral provocation with balsam of Peru and the effect of balsam of Peru-restrictive diets in patients allergic (and also in dermatitis patients not allergic) to MP have been performed, mostly between 1981 and 1996 by one group of Danish investigators.…”

Nickel-Free Alternatives Raise Awareness

“…A low nickel diet has led to symptom improvements in several cases of nickel ACD. 20,45,46 However, dietary avoidance of nickel can be difficult due to nickel in water and soil that may vary by region. 47 Nevertheless, there are certain foods known to have higher nickel content that patients can avoid for a trial of 1 to 2 months to see if their dermatitis improves.…”