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Frequency of contact allergens in pediatric patients with atopic dermatitis

Elise M Herro, Catalina Matiz, Kim Sullivan

    The Journal of Clinical and Aesthetic Dermatology
    |November 30, 2011
    PubMed

    Insights

    Patch testing is crucial for children with moderate-to-severe atopic dermatitis, revealing a high prevalence of contact allergies. Avoiding common allergens like fragrances is recommended for prevention.

    Area of Science:

    • Dermatology
    • Allergology
    • Pediatrics

    Background:

    • Atopic dermatitis (AD) is a chronic inflammatory skin condition often associated with other allergic diseases.
    • Contact allergy is increasingly recognized as a contributing factor in refractory pediatric AD.
    • Systematic evaluation for contact allergens is not routinely performed in pediatric AD management.

    Purpose of the Study:

    • To compare the prevalence of positive patch tests in pediatric patients with and without atopic dermatitis.
    • To identify specific allergens that show statistically significant differences in prevalence between atopic and nonatopic children.
    • To assess the correlation between eczema severity and the number of positive patch test reactions.

    Main Methods:

    • Retrospective chart review of pediatric patients (ages 6-18) with suspected allergic contact dermatitis.
    • Inclusion in the Pediatric Research Equity Act Thin-layer Rapid Use Epicutaneous Test trial.
    • Statistical analysis using Z-scores to compare allergen prevalence between atopic and nonatopic groups.

    Main Results:

    • At least one allergen reaction was observed in 78% of patients; 89% in atopic vs. 66% in nonatopic children.
    • Higher eczema severity (Eczema Area and Severity Index > 10) correlated with more positive patch tests (Z-score [-]3.28).
    • Significant differences noted for Myroxylon pereirae (20% of atopic patients) and fragrance mix (19% of atopic patients).

    Conclusions:

    • Systematic patch testing is indicated for children with moderate-to-severe atopic dermatitis due to high contact allergy rates.
    • Patients with atopic dermatitis and Eczema Area and Severity Index scores > 10 have a higher probability of multiple positive patch tests.
    • Avoidance of frequent contact allergens, particularly fragrances, is recommended for prevention in patients with atopic dermatitis.
    Abstract

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