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Does sensitization to contact allergens begin in infancy?
A L Bruckner1, W L Weston, J G Morelli
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado, USA.
Insights
Pediatric allergic contact sensitization is prevalent, with 24.5% of children under five showing positive reactions to common allergens like nickel and thimerosal. This study confirms that infants can develop sensitization to contact allergens.
Area of Science:
- Pediatric Dermatology
- Allergology
- Immunology
Background:
- Previous research indicates allergic contact sensitization is common in children by age five.
- The prevalence and occurrence of sensitization in infants remain less understood.
Purpose of the Study:
- To determine the prevalence of positive epicutaneous test results in children younger than five years.
- To investigate if sensitization to contact allergens is as common in infancy as in older children.
Main Methods:
- Ninety-five asymptomatic children aged 6 months to 5 years underwent epicutaneous patch testing using the T.R.U.E. Test system.
- Allergens were applied to the skin for 48 hours, with positive reactions evaluated at a follow-up visit.
Main Results:
- Of 85 children who completed the study, 20 (24.5%) exhibited one or more positive reactions to tested allergens.
- Positive reactions were observed in children as young as 6 months, with nickel and thimerosal being the most frequent allergens.
- Fourteen percent of children reacted to nickel, and 10% reacted to thimerosal.
Conclusions:
- Contact allergen sensitization can occur in children as young as six months of age.
- The prevalence of sensitization to common contact allergens in this pediatric cohort is 24.5%.
- Infants may develop sensitization to contact allergens, highlighting the need for early detection and prevention strategies.
Objective:
Because previous studies have found allergic contact sensitization common in children by 5 years of age, our aim was to determine the prevalence of positive epicutaneous test results in children <5 years of age and to determine whether sensitization to contact allergens was as common in infancy.
Methods:
We recruited 95 asymptomatic children 6 months to 5 years of age from well-child visits at Denver area pediatric practices for epicutaneous patch testing using the T.R.U.E. Test system. Allergens were placed on the skin for 48 hours, and at a later follow-up visit, positive reactions were evaluated.
Results:
A total of 85 patients completed the study. Of these, 20 (24.5%) had 1 or more positive reactions to the tested allergens. Positive reactors ranged from 6 to 65.5 months of age, with an average of 30.4 months of age. Of the children, 16 reacted to 1 allergen, and 4 reacted to 2. Eleven positive reactions were observed to nickel, followed by 8 to thimerosal. Other positive reactions were to neomycin, cobalt, and kathon CG.
Conclusions:
Children as young as 6 months of age may be sensitized to contact allergens. Within this pediatric population, the prevalence of sensitization is 24.5%. Sensitization to contact allergens may occur in infants.