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Patch testing in children with hand eczema. A 5-year multicentre study in Spain
Fernando Toledo1, Begoña García-Bravo, Virginia Fernández-Redondo
1Department of Dermatology, Hospital General Universitario de Alicante, Alicante 03010, Spain. fernandotoledoalberola@hotmail.com
Insights
Patch testing is recommended for children with chronic hand eczema, revealing a high prevalence of allergic contact dermatitis. Nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I were common allergens.
Area of Science:
- Dermatology
- Allergology
- Pediatrics
Background:
- Hand eczema is prevalent in children but underdiagnosed.
- Limited research exists on patch testing for pediatric hand eczema.
- This study addresses the gap in understanding contact allergy in this population.
Purpose of the Study:
- To determine the prevalence of contact allergy in children with hand eczema.
- To identify common allergens responsible for hand eczema in children.
- To assess the clinical relevance of identified allergens.
Main Methods:
- Retrospective study over 5 years.
- Involved 480 children (aged 0-15 years) with hand eczema.
- Utilized the Spanish baseline series for patch testing across 11 hospitals.
Main Results:
- 46.8% of children with hand eczema showed positive patch test reactions.
- Nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I were the most frequent allergens.
- Allergic contact dermatitis was the primary diagnosis (36%), followed by atopic dermatitis.
Conclusions:
- Allergic contact dermatitis is a common diagnosis in pediatric hand eczema.
- Patch testing should be considered for all children with chronic hand eczema.
- Findings support routine patch testing similar to adult protocols.
Background:
Hand eczema is common in children, but affected children are seldom patch tested. Relatively few studies have assessed patch testing in the paediatric population, and none has specifically evaluated its use in hand eczema in children.
Objectives:
The aim of this study was to determine the prevalence of contact allergy in children with hand eczema, and to identify the most frequent allergens and their relevance.
Material And Methods:
We performed a 5-year retrospective study of children (aged 0-15 years) with hand eczema tested with the Spanish baseline series at the Dermatology Departments of 11 Spanish hospitals.
Results:
During the study period, 11 729 patients were patch tested, of whom 480 were children. Hand eczema was present in 111 (23.1%) of the children and in 3437 (30.5%) of the adults. Of the children with hand eczema, 46.8% had at least one positive reaction in the patch tests. Current relevance was found for 78% of the allergens detected. The most common allergens were nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I. Allergic contact dermatitis was the most frequent diagnosis (36%), followed by atopic dermatitis.
Conclusions:
Allergic contact dermatitis was the most usual diagnosis in our series of children with hand eczema. We recommend patch testing of all children with chronic hand eczema, as is already performed in adults.
