Allergens responsible for allergic contact dermatitis among children: a systematic review and meta-analysis

Abstract

This meta-analysis offers guidance on which allergens are most prevalent in the paediatric population and should have priority for inclusion in standardized allergen series.

Aetiopathogenesis of atopic dermatitis

“…• rural compared with urban living (hygiene hypothesis) [13,14,17,18] • maternal AD history (parent-of-origin effect) [10,18,19] • higher socioeconomic status [12,14,20] • higher educational level of parents [21] • smaller family size (hygiene hypothesis) [17,22] • improved basic hygiene (hygiene hypothesis) [17] • antibiotic use early in life (hygiene hypothesis) [17,21] • caesarean section delivery [23] • increased maternal age [19] • environmental tobacco smoke (major risk) [13] • contact dermatitis [24,25] • cooler climates [13] • clothing with rough fibres [26] • environmental pollution [13,17] • psychosocial stress. [21,23] The following factors have been shown to decrease the risk for/ prevalence of AD:…”

Non-pharmacological treatment modalities for atopic dermatitis

“…[9] A systematic review and meta-analysis of allergens responsible for allergic contact dermatitis found that the top five allergens in children and adolescents included nickel, ammonium persulphate, gold sodium thiosulphate, thimerosal and p-toluenediamine. [12] Occlusive dressings Findings suggest that wet wraps (cream or ointment applied to the skin, covered by a double layer of cotton bandages, with a moist first layer and a dry second layer, and kept in place for 24 hours) are safe shortterm interventions. The wraps are more efficacious when used together with topical steroids and reduce the absolute amount of topical steroid Table 1.…”

Contact Dermatitis in Children

“…Tables 1 and 2 list the most common allergens detected in a series of investigations. A recent review evaluates 49 studies, most of which included symptomatic patients, finding the five most common allergens to be nickel sulfate, ammonium persulfate, gold sodium thiosulfate, thimerosal and toluene-2,5-diamine (Bonitsis et al, 2011). Table 3 provides prevalence rates of common allergens.…”

“…The importance of palladium alone as a relevant contact allergen is controversial. Similarly, despite a review reporting gold sodium thiosulfate to be a common allergen resulting in positive patch testing, its clinical relevance is debated (Bonitsis et al, 2011). Many who test positive to this allergen can wear gold jewelry without developing a reaction (Andersen & Jensen, 2007).…”