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Published on: October 3, 2019
[Peculiarities of patch testing in children]
1Département de dermatologie, hôpital Saint-Jacques, CHU Besançon, 2, place Saint-Jacques, 25030 Besançon cedex, France. mvigan@chu-besancon.fr
Insights
Contact dermatitis affects 20% of childhood dermatitis cases, yet patch testing is infrequent in younger children. Specialized, safe testing methods are crucial for accurate diagnosis in pediatric patients.
Area of Science:
- Pediatric Dermatology
- Allergy and Immunology
Context:
- Dermatitis is common in children, often presumed atopic.
- Contact dermatitis is underdiagnosed in pediatric populations.
- Current patch testing practices are infrequent for young children.
Purpose:
- To highlight the prevalence of contact dermatitis in children.
- To advocate for increased patch testing in pediatric cases.
- To recommend appropriate and safe patch testing methodologies for children under six.
Summary:
- Contact dermatitis accounts for 20% of childhood dermatitis.
- Children, especially those under six, require specific, safe patch testing protocols.
- Standard series like the European CorePathDirectory standard series may be unsuitable due to metal concentrations; open tests are an alternative.
Impact:
- Improved diagnostic accuracy for pediatric dermatitis.
- Enhanced management strategies for allergic contact dermatitis in children.
- Development of tailored patch testing guidelines for pediatric patients.
Abstract:
Younger children tend to be seen as atopic, patch testing is infrequent, and they tend not to be seen as having contact dermatitis. However, 20% of cases of dermatitis observed during childhood are in fact contact dermatitis and children should therefore undergo patch testing. Before the age of six years, children require testing with a suitable, safe standard series. Certain sources of allergens specific for children such as connubial dermatitis must be sought in order to determine the relevance of positive tests. The concentration of metals in the ECDRG standard series makes it unsuitable for young children and open tests may be used instead.
