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Age-related differences in patch testing results among children: Analysis of North American Contact Dermatitis Group
Jonathan I Silverberg1, Alexander Hou2, Erin M Warshaw3
1Department of Dermatology, George Washington University School of Medicine, Washington, DC; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Insights
Allergic contact dermatitis diagnoses and relevant allergen reactions were similar in children and adults. Common allergens in children include nickel sulfate and cobalt chloride, highlighting the need for comprehensive patch testing.
Area of Science:
- Dermatology
- Allergology
- Pediatric Dermatology
Background:
- Allergic contact dermatitis (ACD) diagnosis and management require updated understanding, especially in pediatric populations.
- Patch testing is crucial for identifying allergens causing ACD.
Purpose of the Study:
- To compare the prevalence of positive and clinically relevant allergic contact dermatitis reactions between children and adults undergoing patch testing.
- To identify common allergens responsible for ACD in children.
Main Methods:
- Retrospective analysis of data from the North American Contact Dermatitis Group (NACDG) database.
- Inclusion of 1871 children and 41,699 adults tested between 2001 and 2018.
- Comparison of diagnostic rates and relevant allergen reactions between pediatric and adult cohorts.
Main Results:
- Similar rates of allergic contact dermatitis diagnosis (55.2% in children vs. 57.3% in adults) and relevant allergen reactions (49.2% vs. 52.2%) were observed between children and adults.
- The most frequent relevant allergens in children were nickel sulfate (17.3%), hydroperoxides of linalool (7.8%), methylisothiazolinone (7.7%), cobalt chloride (7.0%), and fragrance mix I (4.9%).
- Approximately 20% of children experienced reactions to allergens not included in the standard NACDG screening series.
Conclusions:
- Over half of children referred for patch testing received an ACD diagnosis.
- Nickel sulfate, cobalt chloride, and hydroperoxides of linalool were the most common allergens identified in children.
- A significant proportion of children reacted to non-standard allergens, emphasizing the necessity for thorough and comprehensive patch testing protocols.
Background:
An updated understanding of allergic contact dermatitis is needed, particularly in children.
Objectives:
To compare positive and clinically relevant reactions in children versus adults referred for patch testing.
Methods:
Retrospective analysis of 1871 children and 41,699 adults from the North American Contact Dermatitis Group (NACDG) from 2001-2018.
Results:
Both final diagnosis of allergic contact dermatitis (55.2% versus 57.3%; chi square, P = .0716) and prevalence of ≥ 1 currently relevant reaction to a NACDG screening allergen (49.2% vs 52.2%; P = .1178) were similar between children and adults. Currently in children, the most common relevant allergens were nickel sulfate (17.3%), hydroperoxides of linalool (7.8%), methylisothiazolinone (7.7%), cobalt chloride (7.0%), and fragrance mix I (4.9%). Approximately a fifth of children had a positive reaction to a non-NACDG allergen.
Conclusion:
Over half of children referred for patch testing were diagnosed with allergic contact dermatitis. The most common relevant allergens in children were nickel sulfate, cobalt chloride, and hydroperoxides of linalool. Twenty percent of children had at least 1 positive reaction to allergens/substances not on the NACDG screening series, underscoring the need for comprehensive testing.
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