Related Experiment Videos

Patch testing: another steroid-sparing agent to consider in children

Sharon E Jacob1, Cynthia J Burk, Elizabeth Alvarez Connelly

  • 1Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA. sjacob@med.miami.edu

Pediatric Dermatology
|February 29, 2008
PubMed

Insights

Pediatric patch testing is crucial for diagnosing allergic contact dermatitis in children with severe, persistent eczema. Identifying and avoiding allergens can lead to successful treatment and discontinuation of systemic therapies.

Area of Science:

  • Pediatric Dermatology
  • Allergology
  • Contact Dermatitis

Background:

  • Chronic severe dermatitis in children poses a significant burden on patients, families, and healthcare providers.
  • Undiagnosed allergic contact dermatitis (ACD) is a common confounding factor in pediatric eczema.
  • Recalcitrant dermatitis often requires advanced diagnostic and management strategies.

Purpose of the Study:

  • To present a protocol for pediatric patch testing.
  • To illustrate the utility of comprehensive patch testing in managing severe, recalcitrant pediatric dermatitis.
  • To highlight the role of patch testing in identifying allergens and guiding treatment.

Main Methods:

  • Development and implementation of a standardized pediatric patch testing protocol.
  • Case studies of three pediatric patients with severe, treatment-resistant dermatitis.
  • Comprehensive patch testing to identify specific allergen triggers.

Main Results:

  • Patch testing successfully identified culprit allergens in pediatric patients with severe dermatitis.
  • Avoidance of identified allergens, with strict compliance, led to significant clinical improvement.
  • Systemic immunosuppressive therapy was discontinued in the studied cases following allergen identification and avoidance.

Conclusions:

  • Comprehensive patch testing is essential for the accurate diagnosis and effective management of recalcitrant pediatric dermatitis.
  • Identifying and eliminating allergic contact dermatitis triggers can resolve severe eczema in children.
  • Patch testing offers a non-immunosuppressive therapeutic avenue for pediatric allergic contact dermatitis.

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...