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Allergic contact dermatitis in children: the Ottawa hospital patch-testing clinic experience, 1996 to 2006
Marcia Hogeling1, Melanie Pratt
1Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada.
Insights
Patch testing in children reveals common allergens like nickel and cobalt, with results similar to adults. This study identifies key triggers for allergic contact dermatitis in pediatric patients.
Area of Science:
- Dermatology
- Pediatric Allergy
- Contact Dermatitis
Background:
- Allergic contact dermatitis (ACD) is a prevalent issue in pediatric populations.
- Patch testing serves as a crucial diagnostic method for identifying ACD causes in children.
Purpose of the Study:
- To assess the prevalence and clinical significance of positive patch test reactions in pediatric patients.
- To pinpoint the most frequent allergens responsible for ACD in children at a specific clinic.
Main Methods:
- A retrospective analysis of 100 children and adolescents (ages 4-18) who underwent patch testing.
- Utilized the North American Contact Dermatitis Group (NACDG) standard series, supplemented as needed, and patient-specific products.
Main Results:
- 70% of children exhibited at least one positive patch test reaction, with 55.8% deemed clinically relevant.
- Nickel sulfate (26%) and cobalt (14%) were the most prevalent allergens. Other common allergens included fragrance mix, neomycin, colophony, formaldehyde, lanolin, quaternium-15, and para-phenylenediamine.
- Nickel showed co-reactivity with cobalt (68%) and palladium (100%). 41% of tested children had a history of atopic dermatitis.
Conclusions:
- The frequency and relevance of positive patch tests in children mirror adult findings from the NACDG 2001-2002 study.
- Distinct allergen profiles exist between pediatric and adult populations.
- Nickel, cobalt, colophony, lanolin, and para-phenylenediamine were identified as significant allergens in children.
Background:
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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