Patch tests in children with suspected allergic contact dermatitis: a prospective study and review of the literature
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Published on: March 24, 2023
Flora B de Waard-van der Spek1, Arnold P Oranje
1Paediatric Dermatology Unit, Department of Dermatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. f.dewaard@erasmusmc.nl
Insights
Patch testing in children with suspected allergic contact dermatitis (ACD) found 51% had positive reactions. Nickel was the most common allergen, highlighting the need for patch testing in certain pediatric skin conditions.
Area of Science:
- Dermatology
- Pediatrics
- Allergology
Background:
- Allergic contact dermatitis (ACD) is a common skin condition in children.
- Accurate diagnosis is crucial for effective management and prevention.
- Patch testing is a key diagnostic tool for ACD.
Purpose of the Study:
- To prospectively investigate patch testing results in children with suspected ACD.
- To compare findings with existing literature.
- To provide a literature review on patch testing and ACD in children.
Main Methods:
- Seventy-nine children underwent patch testing using the TRUE test, with additional tests for specific agents and emollients.
- Supplementary patch tests were performed based on clinical indications.
- Data on patient demographics and diagnoses were collected.
Main Results:
- 51% of tested children (40 out of 79) showed one or more positive allergic patch test reactions.
- Nickel was the most frequent contact allergen identified.
- Positive reactions were observed in children with atopic dermatitis, hand/foot dermatitis, and other skin conditions.
Conclusions:
- Allergen sensitization can occur from infancy, increasing in toddlers and young children.
- Patch testing is indicated for children aged 5 and over with recalcitrant atopic dermatitis.
- Educating caregivers on ACD prevention is important for managing pediatric skin health.
Aims:
The results of patch testing in children visiting our out-patient clinic with suspected allergic contact dermatitis (ACD) were prospectively investigated and compared with those reported in the literature. A review of the literature on patch testing and ACD in children is provided.
Methods:
Children were patch tested using the TRUE test, supplemented with tixocortol-17-pivalate, budesonide and 3 commonly used emollients. Supplementary patch tests were undertaken on indication.
Results:
Seventy-nine children (31 boys and 48 girls) were patch tested. Of the patients tested, 40 (51%) had 1 or more positive allergic patch test reactions. Twenty-two (55%) of these 40 children suffered from atopic dermatitis, 9 (23%) from hand or foot dermatitis, and 9 (23%) from other skin ailments. Nickel was the most common contact allergen, but many other common and less common allergens were noted to give positive patch tests in patients.
Conclusion:
Sensitization to contact allergens may begin in infancy and continue to be more common in toddlers and young children. In recalcitrant atopic dermatitis, especially at the age of 5 years and over, patch tests are indicated. Good information on preventing the development of ACD in children is useful for caregivers.
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