Expanded Series and Personalized Patch Tests for Children: A Retrospective Cohort Study.

Area of Science:

• Dermatology
• Pediatric Allergy
• Contact Dermatitis Research

Background:

• Epicutaneous patch testing is crucial for diagnosing allergic contact dermatitis (ACD).
• A standardized approach to patch testing in pediatric populations is currently lacking.
• Existing diagnostic tools may not capture all relevant allergens in children.

Purpose of the Study:

• To evaluate patch test positivity in pediatric patients with suspected ACD, differentiating between those with and without atopic dermatitis history.
• To compare the diagnostic yield of the North American 80 Comprehensive Series and personalized patch tests against the Thin-Layer Rapid Use Epicutaneous (T.R.U.E.) Test.
• To identify common allergen exposures in pediatric ACD cases.

Main Methods:

• Analysis of pediatric patients undergoing North American 80 Comprehensive Series or personalized patch testing.
• Assessment of allergen sensitization 48–72 hours post-patch removal.
• Comparison of results between comprehensive/personalized tests and the T.R.U.E. Test, stratified by atopic dermatitis history.

Main Results:

• Out of 29 pediatric patients, 25 showed at least one positive reaction (81 total reactions).
• Nearly half (49.4%) of reactions were from allergens not included in the T.R.U.E. Test.
• Cocamidopropyl betaine was a significant allergen, particularly in patients with atopic dermatitis.

Conclusions:

• Expanded and personalized patch testing offer a more thorough allergen inventory than the T.R.U.E. Test for pediatric ACD.
• Pediatric patients frequently react to allergens found in household products but absent from standard T.R.U.E. Test panels.
• Enhanced patch testing and patient counseling are recommended for managing pediatric ACD.