Contact allergy and allergic contact dermatitis in children and adolescents with chronic eczema

R. Spiewak, E. Grubska-Suchanek, M. Pasnicki, A. Krakowski, A. Cisowska.

Jagiellonian University Medical College, Department of Experimental Dermatology and Cosmetology, Krakow, Poland

Source: Spiewak R, Grubska-Suchanek E, Pasnicki M, Krakowski A, Cisowska A. Contact allergy and allergic contact dermatitis in children and adolescents with chronic eczema. Allergy 2012; 67 (Suppl 96: European Academy of Allergy and Clinical Immunology Congress 2012. Geneva, 16-20 June 2012): 472.

Background: Patch test is the gold standard of eczema diagnosis in every age group. The prevalence of allergic contact dermatitis (ACD) in children and adolescents is comparable to that of atopic dermatitis.

The aim of the present study was to analyse the frequency of contact allergy and ACD in children and adolescents with chronic eczema.

Methods: KRAK study is a multi-centre patch test study of patients with chronic eczema. Eleven participating Polish dermatology and allergy centres submit data of all patients patch tested with the Polish Baseline Series (Chemotechnique Diagnostics). The series consists of the European Baseline Series plus propolis and palladium - two relevant sensitizers in Polish paediatric and adult populations. Among all data submitted in 2011 by the KRAK study group members, 127 patch test results of children (0-13 y.o., N=64) and adolescents (14-20 y.o., N=63) were identified and included into the present study.

Results: Altogether, 127 children and adolescents (36 boys and 91 girls) were patch tested in 5 out of 11 participating centres. At least one positive reaction to haptens from the Polish Baseline Series was recorded in 83 patients (65.4%). In 59 patients (46.5%), the tests were considered clinically relevant (i.e. were deemed as the ultimate cause of their eczema). The figures for frequent sensitizers (at least 3% of the study group) are shown in the table below. No differences in sensitization rates were observed between prepubertal boys and girls (0-13 y.o.). Among adolescents, girls were more frequently sensitized to nickel (46.9% vs 14.3% in boys, p=0.058), while boys were more frequently sensitized to Fragrance mix I (28.6% vs 4.1% in girls, p=0.025). There was also a tendency to more frequent propolis sensitization among boys (both age groups combined: 16.7% vs 6.6% in girls, p=0.080). Also interestingly, 4 patients (3.1%) reacted to palladium but not to nickel, suggesting that under modern environmental exposures palladium is not just a mere cross-reactivity to nickel, as believed previously.

Conclusion: Allergic contact dermatitis is a frequent cause of eczema in children and adolescents. These patients are most frequently sensitized to metals and cosmetic ingredients. Natural remedies containing balsam of Peru and propolis should be avoided in children with eczema due to frequent sensitizations. Palladium and propolis are frequent sensitizers and should be included into routine patch testing of children.

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Links:

Patch testing in Krakow (Cracow), Poland

Institute of Dermatology, Krakow, Poland

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  1. Spiewak R. Patch testing for contact allergy and allergic contact dermatitis. Open Allergy J 2008, 1: 42-51.
  2. Spiewak R. Atopy and contact hypersensitivity: a reassessment of the relationship using objective measures. Ann Allergy Asthma Immunol 2005, 95 (1): 61-65.
  3. Spiewak R, Pietowska J, Curzytek K. Nickel: a unique allergen - from molecular structure to European legislation. Expert Rev Clin Immunol 2007, 3 (6): 851-859.
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  6. Spiewak R, Grubska-Suchanek E, Pasnicki M, Krakowski A, Cisowska A. Contact allergy and allergic contact dermatitis in children and adolescents with chronic eczema. Allergy 2012; 67 (Suppl 96): 472.
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  11. Spiewak R, Samochocki Z, Grubska-Suchanek E, Czarnobilska E, Pasnicki M, Czarnecka-Operacz M, Bukiel M, Cisowska A, Jedrzejewska-Jurga K, Krakowski A, Niklasson B. Gallates, as well as hydroperoxides of limonene and linalool, are more frequent and relevant sensitizers than any cosmetic ingredient included in the European Baseline Series. Contact Dermatitis 2016; 75 (S1): 87.

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Document created: 29 May 2017, last updated: 30 May 2017.