Which children should we patch test?

Area of Science:

• Pediatric Dermatology
• Allergology
• Contact Dermatitis

Background:

• Childhood allergic contact dermatitis (ACD) was once rare but is now increasingly reported.
• This rise may be due to increased allergen exposure and more frequent patch testing in children.
• Changes in children's environmental exposures likely contribute to the growing incidence of ACD.

Purpose of the Study:

• To identify common contact allergens in children with suspected allergy.
• To determine the rate of positive patch-test reactions in pediatric patients.
• To analyze allergen prevalence based on dermatitis presentation and location.

Main Methods:

• Retrospective case study of 114 children aged 3–15 years undergoing patch testing over three years.
• Patch testing included standard series, medicament series, and specific series for corticosteroids, shoes, fragrances, cosmetics, and rubber.
• Indications for testing included uncontrolled atopic dermatitis, localized dermatitis, or known allergen reactions.

Main Results:

• 54% of children showed relevant positive patch-test reactions.
• Nickel was the most frequent allergen (20%), followed by rubber chemicals (10%) and fragrance (7.2%).
• Higher positive reaction rates were observed in children with eyelid (86%) and hand (71%) dermatitis.

Conclusions:

• The incidence of childhood ACD, particularly nickel and rubber allergies, is increasing, possibly due to evolving fashions and hobbies.
• Contact allergy should be considered in all children presenting with dermatitis.
• Increased frequency of patch testing is advised for pediatric patients with suspected contact allergy, especially those with eyelid or hand dermatitis.