Countering Staphylococcus Overgrowth During Patch Testing in Children with Moderate to Severe Atopic Dermatitis

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Shehla Admani1, Catalina Matiz2, Sharon E Jacob3,4

  • 1Department of Dermatology, University of California at San Diego, San Diego, California.

Pediatric Dermatology
|December 10, 2015
PubMed

Insights

Patch testing is feasible in patients with atopic dermatitis (AD) and concerns for Staphylococcus aureus overgrowth. Interventions can help manage complications and yield accurate diagnostic results for refractory AD.

Area of Science:

  • Dermatology
  • Allergy and Immunology
  • Infectious Diseases

Background:

  • Moderate to severe atopic dermatitis (AD) frequently co-occurs with contact dermatitis.
  • Patch testing in AD patients poses challenges due to barrier impairment and potential bacterial overgrowth.
  • Staphylococcus aureus colonization is common in AD, creating risks during patch testing.

Purpose of the Study:

  • Identify patients at risk for S. aureus overgrowth during patch testing.
  • Provide interventions for pre- and peripatch testing to optimize results in complex AD populations.
  • Evaluate the safety and efficacy of patch testing in AD patients with S. aureus concerns.

Main Methods:

  • Retrospective review of five patients with moderate to severe AD.
  • Analysis of cases where S. aureus overgrowth complicated patch testing.
  • Clinical observation of complications and outcomes during patch testing.

Main Results:

  • All five patients successfully completed patch testing with relevant positive reactions.
  • Complications included erythema, oozing, odor, and purulent material at patch sites.
  • One patient's culture confirmed methicillin-sensitive S. aureus.

Conclusions:

  • Patch testing is valuable for managing refractory atopic dermatitis.
  • Concerns about S. aureus overgrowth should not prevent patch testing in AD patients.
  • Appropriate interventions can mitigate complications and ensure diagnostic accuracy.
Abstract

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