Allergic contact dermatitis in children is a significant clinical problem. Patch testing is a diagnostic tool for the evaluation of patients with suspected allergic contact dermatitis.
Objectives:
To determine the frequency and relevance of positive patch-test results in children and to identify the most common allergens in children at our clinic.
Methods:
Retrospective chart review of 100 children and adolescents, aged 4 to 18 years, who were patch-tested at the Ottawa Hospital patch-testing clinic between 1996 and 2006. The children were patch-tested with the North American Contact Dermatitis Group (NACDG) standard series, supplementary series if indicated, and their own products if available.
Results:
Seventy percent of children had at least one positive patch-test reaction; 55.8% of positive patch-test reactions were relevant. The ratio of females to males was 62:38. The most common allergens were nickel sulfate (26%), cobalt (14%), fragrance mix (7%), neomycin (7%), colophony (6%), formaldehyde (4%), lanolin (4%), quaternium-15 (4%), and para-phenylenediamine (4%). Nickel co-reacted with cobalt (68%) and palladium (100%). Of children tested, 41% had a history of atopic dermatitis.
Conclusions:
The frequency of positive and relevant allergens in children is similar to that in adults as compared with data from the NACDG 2001-2002 study period. Differences between the top 10 allergens in children and adults were seen. Nickel and cobalt were more common allergens in children, and colophony, lanolin, and para-phenylenediamine ranked in the top 10 allergens among children.
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References
1.
MortzCG, AndersenKE. Allergic contact dermatitis in children and adolescents. Contact Dermatitis, 1999; 41:121-30.
2.
MortzCG, LauritsenJM, Bindsley-JensenC, AndersenKE. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis. Br J Dermatol, 2001; 144:523-32.
3.
SeidenariS, GiustiF, PepeP, MantovaniL. Contact sensitization in 1094 children undergoing patch testing over a 7-year period. Pediatr Dermatol, 2005; 221:1-5.
HanifinJM, RajkaG. Diagnostic features of atopic dermatitis. Acta Derm Venereol (Stockh), 1980; 92Suppl:44-7.
7.
MarksJG, BelsitoDV, DeLeoVA, et al.North American Contact Dermatitis Group patch test results for the detection of delayed hypersensitivity to topical allergens. J Am Acad Dermatol, 1998; 38: 911-8.
8.
MarksJG, BelsitoJV, DeLeoVA, et al.North American Contact Dermatitis Group standard tray patch test results (1992-1994). Am J Contact Dermat, 1995; 6:160-5
9.
GoonAT, GohCL. Patch testing of Singapore children and adolescents: our experience over 18 years. Pediatr Dermatol, 2006; 23:117-20.
BeattiePE, GreenC, LoweG, Lewis-JonesMS. Which children should we patch test?. Clin Exp Dermatol, 2007; 32:6-11.
12.
KrobAH, FleischerAB, D'AgostinoRJr, et al. Prevalence and relevance of contact dermatitis allergens: a meta-analysis of 15 years of published T.R.U.E. Test data. J Am Acad Dermatol, 2004; 51:349-53.
13.
ClaytonTH, WilkinsonSM, RawcliffeC, et al. Allergic contact dermatitis in children: should pattern of dermatitis determine referral? A retrospective study of 500 children tested between 1995 and 2004 in one U.K. centre. Br J Dermatol, 2006; 154:114-7.
14.
RoulS, DucombsG, TaiebA. Usefulness of the European standard series for patch testing in children. A 3-year single centre study of 337 patients. Contact Dermatitis, 1999; 40:232-5.
15.
DotterudLK, FalkES. Metal allergy in north Norwegian schoolchildren and its relationship with ear piercing and atopy. Contact Dermatitis, 1994; 31:308-13.
16.
BraschJ, GeierJ. Patch test results in schoolchildren. Results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG). Contact Dermatitis, 1997; 37:286-93.
17.
KuttingB, BrehlerR, TraupeH. Allergic contact dermatitis in children—strategies of prevention and risk management. Eur J Dermatol, 2004; 14:80-5.
18.
SostedH, JohansenJD, AndersenKE, MenneT. Severe allergic hair dye reactions in 8 children. Contact Dermatitis, 2006; 54:87-91.
19.
PrattMD, BelsitoDV, DeLeoVA, et al.North American Contact Dermatitis Group patch-test results 2001-2002 study period. Dermatitis, 2004; 15:176-83.
20.
WestonWL, MorelliJG. Dermatitis under soccer shin guards: allergy or contact irritant reaction?. Pediatr Dermatol, 2006; 23: 19-20.
21.
SommerS, WilkinsonSM, DodmanB. Contact dermatitis due to urea-formaldehyde resin in shin pads. Contact Dermatitis, 1999; 40: 159-60.
22.
Giordano-LabadieF, RanceF, PellegrinF, et al.Frequency of contact allergy in children with atopic dermatitis: results of a prospective study of 137 cases. Contact Dermatitis, 1999; 40:192-5.
23.
ManziniBM, FerdaniG, SimonettiV, et al.Contact sensitization in children. Pediatr Dermatol, 1998; 15:12-7.
24.
ShahM, LewisFM, GawkrodgerDJ. Patch testing in children and adolescents: five years' experience and follow-up. J Am Acad Dermatol, 1997; 37:964-8.
