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Patch testing with cobalt in children and adolescents: North American contact dermatitis group experience, 2001-2018
Jonathan I Silverberg1,2, Nisha Patel1, Erin M Warshaw3,4,5
1Department of Dermatology, George Washington University School of Medicine, Washington, District of Columbia, USA.
Insights
Cobalt allergy is common in children, with jewelry and clothing being frequent sources. Affected body areas varied by the source of cobalt exposure in children with allergic contact dermatitis.
Area of Science:
- Pediatric Dermatology
- Allergology
- Contact Dermatitis
Background:
- Allergic contact dermatitis (ACD) to cobalt is increasingly recognized in pediatric populations.
- Limited data exists on specific cobalt exposure sources and affected body sites in children.
Purpose of the Study:
- To evaluate trends in cobalt patch test reactions in children.
- To identify patient characteristics, common exposure sources, and affected body sites associated with cobalt allergy.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) patch tested for cobalt.
- Data collected by the North American Contact Dermatitis Group from 2001 to 2018.
Main Results:
- 11.9% of children had positive patch tests for cobalt; 6.6% showed currently relevant reactions.
- Commonly affected sites included generalized scattered areas, face, and trunk.
- Jewelry, belts, and clothing were identified as primary sources of cobalt exposure.
Conclusions:
- Positive cobalt patch test reactions are prevalent in children.
- The distribution of affected body sites varied depending on the cobalt source.
Background:
Allergic contact dermatitis (ACD) to cobalt is more common in children and adolescents than adults. However, detailed information on sites and sources of cobalt ACD is limited.
Objectives:
To assess trends in positive and clinically relevant patch test reactions to cobalt in children and associated patient characteristics, common sources and body sites affected.
Methods:
A retrospective analysis of children (<18 years) patch tested to cobalt by the North American Contact Dermatitis Group between 2001 and 2018.
Results:
Of 1919 children patch tested, 228 (11.9%) and 127 (6.6%) had a positive/allergic or currently relevant patch test reaction to cobalt, respectively. The most common primary body sites affected were scattered generalized (30.0%), face, not otherwise specified (10.6%) and trunk (10.1%). Patients with allergic and currently relevant allergic patch test reactions were more likely to have a primary site of trunk (p = 0.0160 and p = 0.0008) and ears (p = 0.0005 and p < 0.0001). Affected body site(s) varied by cobalt source among patients with currently relevant reactions, especially for less common sources. The most commonly identified sources of cobalt included jewellery, belts and clothing.
Conclusions:
Positive patch test reactions to cobalt were common in children. The most common body site was scattered generalized and the sources of cobalt varied by body site.
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