Related Experiment Video
Updated: Jul 19, 2026
Precision Implementation of Minimal Erythema Dose MED Testing to Assess Individual Variation in Human Inflammatory Response
Published on: October 3, 2019
Hand eczema in children referred for patch testing: North American Contact Dermatitis Group Data, 2000-2016
J I Silverberg1,2, E M Warshaw3,4,5, H I Maibach6
1Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Insights
Pediatric hand eczema (HE) has distinct allergens, with nickel and methylisothiazolinone being common. Patch testing reveals similar positive rates in children with and without HE.
Area of Science:
- Dermatology
- Allergology
- Pediatrics
Background:
- Etiologies and relevant allergens for pediatric hand eczema (HE) are not well understood.
- Characterizing these factors is crucial for effective diagnosis and management in children.
Purpose of the Study:
- To identify the causes and common allergens in children and adolescents under 18 with hand eczema.
- To determine the prevalence of positive and currently relevant allergens in this pediatric population.
Main Methods:
- Retrospective analysis of North American Contact Dermatitis Group data from 2000-2016.
- Inclusion of 1634 pediatric patients, with a focus on the 237 diagnosed with hand eczema.
- Utilized multivariable logistic regression to identify associations and relevant allergens.
Main Results:
- Allergic contact dermatitis (49.4%), atopic dermatitis (37.1%), and irritant contact dermatitis (16.9%) were key diagnoses in pediatric HE.
- Children with HE showed similar positive patch test rates (56.1%) compared to those without (61.7%).
- Top relevant allergens included nickel, methylisothiazolinone, propylene glycol, decyl glucoside, and lanolin, with HE associated with specific allergens like lanolin and quaternium-15.
Conclusions:
- Pediatric patients with hand eczema referred for patch testing exhibit a high rate of positive results, comparable to controls.
- A distinct, relatively narrow profile of currently relevant allergens was identified in children with hand eczema.
Background:
Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE).
Objectives:
To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing.
Methods:
A retrospective analysis (2000-2016) of North American Contact Dermatitis Group data was performed.
Results:
Of 1634 paediatric patients, 237 (14·5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49·4%), atopic dermatitis (37·1%) and irritant contact dermatitis (16·9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56·1% vs. 61·7%; χ2 -test, P = 0·11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. The allergens with the highest mean significance-prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone.
Conclusions:
Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to the proportion found in children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.
