Background: The prevalence of allergic contact dermatitis in children and adolescents is comparable to that of atopic dermatitis, moreover, there is a considerable comorbidity. Therefore, patch test is the gold standard of diagnostic work-up in every patient with chronic or recurrent eczema, regardless the preliminary diagnosis. The aim of the present study was to analyse the frequency of contact allergy and allergic contact dermatitis in children and adolescents with chronic or recurrent dermatitis.
The aim of the present study was to analyse the frequency of contact allergy and allergic contact dermatitis in children and adolescents with chronic or recurrent dermatitis.
Methods: Presented data were collected during the Phase 2 of the KRAK Study - a multi-centre observational study of patients with chronic or recurrent eczema. Ten dermatology and allergy centres (from university clinics to private consultancies) participated in this network by submitting clinical data of all patients qualified for routine patch testing, i.e. all new patients with chronic or recurrent dermatitis. The patch test series was the European Baseline Series expanded to 50 substances (single haptens or hapten mixes) applied in IQ Ultra test units (Chemotechnique Diagnostics). The loaded patch tests units were mounted on the patient's back for 2 days and read at least twice during an observation period of minimum 3 days following removal of the units (total test duration 5-8 days). The results were recorded in line with the ICDRG criteria, while clinical relevance of positive reactions was assessed with the use of the CODEX score.
Results: Altogether, 171 children aged 0.5-13 (median 6) years and 119 adolescents aged 14-21 (median 18) years were patch tested. At least one positive reaction was recorded in 119 children (70%) and 70 adolescents (59%). In 55 children (32%) and 44 adolescents (37%), the tests were considered clinically relevant, leading to the ultimate diagnosis of allergic contact dermatitis. The "top ten" sensitizers among children with eczema were nickel (33%), chromium, palladium and limonene (16% each), cobalt (15%), linalool and gentamicin (12% each), gallates (11%), methylisothiazolinone (6%) and propolis (5%). Top ten sensitizers among adolescents were nickel (20%), palladium (14%), cobalt (13%), limonene (12%), linalool (10%), methylisothiazolinone (9%), chromium and gallates (8% each), paraphenylenediamine (7%) and textile azo dye disperse orange 3 (6%).
Conclusion: Contact allergy is a frequent cause or complication of eczema in children and adolescents. The major sources of sensitization in these groups are metals and cosmetics.
Patch testing in Krakow (Cracow), Poland
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Document created: 29 May 2017, last updated: 30 May 2017.