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Patch test reactions in children, adults and the elderly. A comparative study in patients with suspected allergic
Insights
Patch testing reveals age and sex differences in allergic contact dermatitis. Nickel and thimerosal are common allergens, with varying prevalence across age groups and genders, highlighting the need for testing in children and the elderly.
Area of Science:
- Dermatology
- Allergology
- Epidemiology
Background:
- Allergic contact dermatitis (ACD) prevalence varies by age and sex.
- Understanding allergen distribution is crucial for diagnosis and prevention.
Purpose of the Study:
- To investigate the age- and sex-related distribution of positive patch test reactions.
- To identify common contact allergens across different demographic groups.
Main Methods:
- Patch testing was performed on 234 children, 1200 adults, and 295 elderly patients.
- A European standard series of allergens was used.
- Data was analyzed based on age groups (0-7, 8-14, 20-50, >=70 years) and sex.
Main Results:
- Females generally showed more positive reactions than males.
- In children, thimerosal and nickel were frequent allergens.
- Elderly patients had lower reaction rates, with nickel and balsam of Peru noted.
- Thimerosal and ethylmercuric chloride were common in males, while nickel and thimerosal predominated in females.
Conclusions:
- Patch testing is indicated for children and elderly patients with suspected ACD.
- Allergen prevalence differs significantly by age and sex.
- Specific allergens like nickel, thimerosal, ethylmercuric chloride, and balsam of Peru show distinct distribution patterns.
Abstract:
The age- and sex-related distribution of positive patch test reactions was investigated in 234 children (0-7 years, n = 72 and 8-14 years, n = 162), 1200 adults (20 to 50 years) and 295 elderly patients (> or = 70 years) with suspected allergic contact dermatitis using a European standard series. In girls from 0 to 7 years, the most frequent contact allergens were thimerosal (37.5%) and nickel (27.5%), in girls from 8 to 14 years, nickel (28.7%) and thimerosal (26.6%), in women, thimerosal (25.3%) and nickel (25.2%), and in elderly women, nickel (12.6%) and balsam of Peru (9.7%). The most frequent contact allergens in boys from 0 to 7 years were ethylmercuric chloride (28.1%) and thimerosal (25.0%), in boys from 8 to 14 years, thimerosal (30.9%) and ethylmercuric chloride (14.7%), in men, thimerosal (21.1%) and ethylmercuric chloride (13.7%) and in elderly men, nickel (11.2%) and balsam of Peru (6.7%). Females showed more positive reactions than males. Whilst 0 to 7 year-old girls and boys showed relatively more frequent reactions, the elderly of both sexes were clearly less affected. Nickel is the most frequent contact allergen in females of 8 years and more. In men, thimerosal is most frequent and reactions to balsam of Peru show a peak incidence in the elderly. Results indicate that patch testing should be considered in children and elderly patients with appropriate indications.