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Contact Allergy in Children in Europe: A Proposal for a Paediatric European Baseline Series
Anne Birgitte Simonsen1, Thomas Rustemeyer2, Suzana Ljubojevicé Hadzavdic3
1National Allergy Research Centre, Department of Allergy, Skin and Venerology, Gentofte Hospital, Gentofte Hospitalsvej 20A, Hellerup, University of Copenhagen, Institute of Clinical Medicine Denmark, Copenhagen, Denmark.
Insights
A common European patch test series for children is proposed, identifying frequent allergens like metals and fragrances. This aims to improve diagnosis of contact allergy in pediatric patients across Europe.
Area of Science:
- Dermatology
- Allergology
- Pediatrics
Background:
- Contact allergy is prevalent in children.
- No standardized European paediatric baseline series (pEBS) currently exists.
- Existing recommendations highlight the need for a pEBS.
Purpose of the Study:
- To establish a common paediatric baseline series (pEBS) for Europe.
- To compare patch testing data from multiple European centers.
- To potentially adapt the pEBS by age group.
Main Methods:
- Aggregated patch testing data from 13 centers in 12 European countries (2018-2022).
- Included 1816 children aged 0-16 years.
- Used adult baseline series (aEBS) criteria with a stricter 1% positive reaction cut-off for allergen inclusion.
Main Results:
- Identified 18 allergens potentially qualifying for a pEBS, with 7 additional recommended allergens.
- Common allergens included metals, fragrances, and preservatives.
- Tixocortol-21-pivalate, hydroperoxides of limonene and linalool, Amerchol L-101, and sorbitan sesquioleate were noted.
Conclusions:
- Patch testing data reveals a common set of frequent allergens in European children.
- These identified allergens should inform the development of a paediatric baseline series (pEBS).
- A standardized pEBS is crucial for diagnosing pediatric contact allergy.
Background:
Contact allergy is common in children, but no paediatric baseline series (pEBS) exists in Europe, despite recommendations in several countries.
Objectives:
To collect and compare patch testing data from European centres to propose a common pEBS, possibly adapted by age group.
Materials And Methods:
Data from 13 centres in 12 European countries were aggregated, covering 1816 children (1099 girls, 60.5%), aged 0-16 years, tested with the adult EBS (aEBS) and other frequent allergens between 2018 and 2022. Allergen selection followed adult criteria, with a stricter cut-off for inclusion, requiring at least 1% positive reactions (lower 95% CI) in children.
Results:
A total of 17 allergens from the aEBS caused positive reactions in ≥ 1% of children (lower 95% CI). Common allergens included metals, fragrances, and preservatives. Tixocortol-21-pivalate was included despite its lower frequency due to its difficult-to-suspect nature. Additional frequent allergens were hydroperoxides of limonene and linalool, Amerchol L-101, and sorbitan sesquioleate. In total, 18 allergens were identified as potentially qualifying for a pEBS, with a further 7 as recommended additions.
Conclusion:
Results from patch testing children across europe highlight a common set of frequent allergens, which should be considered for a pEBS.
