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Published on: October 3, 2019
Clinically relevant patch test reactions in children--a United States based study
Sharon E Jacob1, Bruce Brod, Glen H Crawford
1Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA. sjacob@contactderm.net
Insights
Allergic contact dermatitis is common in children with persistent eczema, with 83% showing positive patch tests. Clinically relevant allergies were found in 77% of pediatric patients, highlighting the need for allergy testing.
Area of Science:
- Dermatology
- Pediatric Allergy
- Contact Dermatitis
Background:
- Allergic contact dermatitis (ACD) prevalence in children is underestimated.
- Patch testing is crucial for diagnosing ACD in pediatric patients.
Purpose of the Study:
- Confirm prevalence of clinically relevant ACD in children.
- Identify common contact allergens in pediatric patients.
- Assess the clinical relevance of patch test reactions in children.
Main Methods:
- Retrospective case series analysis of 65 children (aged 1-18) with recalcitrant dermatitis.
- Patch testing performed over a 5-year period at two referral centers.
- Evaluation of positive patch test reactions for clinical relevance.
Main Results:
- 83% of children (54/65) had positive patch test reactions to 80 allergens.
- 77% of children (50/65) had reactions of definite or probable clinical relevance.
- Common allergens were identified, though not specified in the abstract.
Conclusions:
- Allergic contact dermatitis is common in children referred for patch testing.
- Contact allergy should be considered in pediatric patients with recalcitrant dermatitis.
- Patch testing is valuable for identifying specific allergens in children.
Abstract:
Allergic contact dermatitis in the pediatric population is more common than previously recognized, with recent prevalence estimates of positive patch test reactions in the range of 14-70% of children patch tested. The aim of this study was to confirm the prevalence of clinically relevant allergic contact dermatitis in children at two referral centers and determine the most common contact allergens. We performed a retrospective case series analysis of 65 symptomatic children (35 girls and 30 boys) aged 1-18 years old who were patch tested over a 5-year period for recalcitrant dermatitis. Positive patch test reactions were noted in 54 of the 65 children (prevalence rate of 83%) to 80 different allergens. Fifty children (77%) had positive reactions which were determined to be of "definite" or "probable" current clinical relevance. We conclude that the diagnosis of allergic contact dermatitis to specific relevant allergens is common in children referred for patch testing and that contact allergy should be considered in all children with recalcitrant dermatitis. With this article, we review the literature and present a US based study regarding the clinical relevance of positive patch test reactions in children.
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