Contact Allergy in Children

Abstract

Contact allergy in children is more frequent than previously suspected. Metals, ingredients of pharmaceutical and cosmetic products, preservatives/biocides, para-phenylenediamine, rubber additives, plastics and resins, and plants are known sensitizers in them. In adolescents, occupation-induced allergens may be involved as well. Sometimes unusual clinical presentations of allergic contact dermatitis can be observed. If there is a suspicion by history and clinical picture, or there is an unexplained eczema at particular body sites, patch testing should be performed at all ages. Patch testing in children is safe, but false-positive (as false-negative) reactions are, of course, possible. Patch test reactions must be interpreted carefully, particularly in atopic subjects, since their skin is readily irritated; this is especially the case for metals. An abbreviated baseline series, supplemented with relevant allergens from other test series, as well as contacted products and respective ingredients suggested by the history, should be patch tested.

Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium

“…17 Other recent European studies show even higher rates in their selected patient population (46.7% and 46%, respectively 3,18 ), while the prevalence rates in North America are even significantly higher. 12,17,19 The mean age of our patch tested children was 10.9, which is younger than reported in some other recent studies, that is, 13.3 and 14.5 years, respectively. 18,20 A female predominance (ratio almost 2:1) was noted in children with a positive patch test, which confirms the results of most previous studies.…”

“…In Belgium hairdressing courses are organized from the third year of secondary school, which corresponds to the age at which we observed PPD positives; however, some of them may have been primarily sensitized at a younger age by black henna tattoos. 12,25 Finally, we would like to underline the high ranking of isobornyl acrylate in our study results, which is a relatively "new kid on the block" within the contact allergens, being present in glucose sensors and insulin pumps. This allergen should therefore always be tested if ACD from a medical device is suspected in a child with diabetes.…”

“…The ten most frequent contact allergens observed in our population (Table 2) are consistent with the literature in this regard, being metals, fragrances, PPD, ingredients of topical pharmaceutical products and cosmetics, and Compositae plants. 12 Nickel sulfate is the most frequently reported allergen in children worldwide, 21 despite the EU Nickel Directive since 2001, 23 possibly because of nickel-containing toys imported from non-European countries that do not have to comply with these restrictions. 12 wipes), essential oils, diffusers, scented candles, and incense.…”

“…A recent case–control study has indicated that contact allergens show age‐specific patterns, 11 which are due to variations in specific exposures to sensitizers. Small children are not often referred for patch testing, as they have a smaller patch test area; moreover, many parents are reluctant to it 12,13 . Further investigation of contact allergy and ACD in the paediatric population is necessary though to perform more accurate testing in the future.…”

“…Small children are not often referred for patch testing, as they have a smaller patch test area; moreover, many parents are reluctant to it. 12,13 Further investigation of contact allergy and ACD in the paediatric population is necessary though to perform more accurate testing in the future.…”