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Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group
Kathryn A Zug1, Anh Khoa Pham, Donald V Belsito
1From the *Section of Dermatology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; †Geisel School of Medicine at Dartmouth, Hanover, NH; ‡Columbia University Medical Center, New York, NY; §University of Toronto, Ontario, Canada; ∥St Luke's Roosevelt Hospital Center, Columbia University, New York, NY; ¶University of Louisville, KY; #Associates in Dermatology, Fort Myers, FL; **University of California-San Francisco; ††Penn State Milton S. Hershey Medical Center, Hershey, PA; ‡‡Department of Dermatology, Group Health Associates, Cincinatti, OH; §§University of Ottawa, Ontario; ∥∥McGill University Health Centre, Montreal, Quebec, Canada; ¶¶Oregon Health Science University, Portland, OR; ##Cleveland Clinic, OH; ***Department of Dermatology, Minneapolis VA Health Care System, University of Minnesota; and †††Ohio State University, Columbus.
Insights
Pediatric allergic contact dermatitis is common. Patch testing in children from 2005-2012 revealed nickel, cobalt, and neomycin as frequent allergens, with results similar to previous studies and adults.
Area of Science:
- Dermatology
- Allergology
- Pediatric Health
Background:
- Allergic contact dermatitis (ACD) is a prevalent condition in pediatric populations.
- Epicutaneous patch testing serves as a critical diagnostic method for identifying causative allergens in ACD.
Purpose of the Study:
- To analyze patch test results in children (≤18 years) evaluated by the North American Contact Dermatitis Group between 2005 and 2012.
- To compare these findings with historical data and adult populations.
Main Methods:
- Retrospective analysis of patch test data from 883 children.
- Utilized the North American Contact Dermatitis Group 65- or 70-allergen series.
- Compared frequencies of positive reactions with previous data (2001-2004) using chi-squared statistics.
Main Results:
- 62.3% of children exhibited at least one positive patch test; 56.7% had a relevant positive reaction.
- Nickel sulfate, cobalt chloride, neomycin sulfate, balsam of Peru, and lanolin alcohol were the most common allergens.
- No significant difference in overall positive or relevant positive patch tests was observed between children and adults, or compared to previously tested children (2001-2004).
- Significant differences in clinically relevant positive patch tests for 27 allergens were noted between children and adults.
- 23.6% of children had a relevant positive reaction to at least one supplemental allergen.
Conclusions:
- Periodic updates on pediatric patch testing are essential for clinical awareness.
- Findings highlight the importance of ongoing surveillance for common and emerging allergens in pediatric ACD.
- The study underscores the need for clinicians to remain vigilant regarding allergens causing relevant positive patch tests in children.
Background:
Allergic contact dermatitis is common in children. Epicutaneous patch testing is an important tool for identifying responsible allergens.
Objective:
The objective of this study was to provide the patch test results from children (aged ≤18 years) examined by the North American Contact Dermatitis Group from 2005 to 2012.
Methods:
This is a retrospective analysis of children patch-tested with the North American Contact Dermatitis Group 65- or 70-allergen series. Frequencies and counts were compared with previously published data (2001-2004) using χ statistics.
Conclusions:
A total of 883 children were tested during the study period. A percentage of 62.3% had ≥1 positive patch test and 56.7% had ≥1 relevant positive patch test. Frequencies of positive patch test and relevant positive patch test reaction were highest with nickel sulfate (28.1/25.6), cobalt chloride (12.3/9.1), neomycin sulfate (7.1/6.6), balsam of Peru (5.7/5.5), and lanolin alcohol 50% petrolatum vehicle (5.5/5.1). The ≥1 positive patch test and ≥1 relevant positive patch test in the children did not differ significantly from adults (≥19 years) or from previously tested children (2001-2004). The percentage of clinically relevant positive patch tests for 27 allergens differed significantly between the children and adults. A total of 23.6% of children had a relevant positive reaction to at least 1 supplemental allergen. Differences in positive patch test and relevant positive patch test frequencies between children and adults as well as test periods confirm the importance of reporting periodic updates of patch testing in children to enhance clinicians' vigilance to clinically important allergens.