Contact Dermatitis in the Atopic Child

Kwan, Julia M.; Jacob, Sharon E.

doi:10.3928/00904481-20120924-15

Cited by 8 publications

(4 citation statements)

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“…3 AD was traditionally considered an immune-mediated condition, driven primarily by T helper (Th) 2 cells, 4 and individuals with AD were considered less likely to have allergic contact dermatitis (ACD) owing to suppressed Th1-mediated cellular immunity. 5,6 Lately, this hypothesis has been challenged, and it is currently a topic of debate as to whether AD is caused primarily by a dysfunctional innate and adaptive immune system and an imbalance between Th1 and Th2 cells, or a primary skin barrier defect with immunological changes secondary to this, promoted by the invasion of trigger factors such as allergens and microbes. 7 ACD is a type IV delayed hypersensitivity reaction that typically develops after repeated or prolonged topical exposure to chemical allergens.…”

Section: What Does This Study Add?mentioning

confidence: 99%

“…Although the pathogenesis of AD is complex and multifactorial, the disease has a common phenotypic expression, characterized by dry and itchy skin with chronic or recurrent episodes of dermatitis at typical anatomical sites . AD was traditionally considered an immune‐mediated condition, driven primarily by T helper (Th)2 cells, and individuals with AD were considered less likely to have allergic contact dermatitis (ACD) owing to suppressed Th1‐mediated cellular immunity . Lately, this hypothesis has been challenged, and it is currently a topic of debate as to whether AD is caused primarily by a dysfunctional innate and adaptive immune system and an imbalance between Th1 and Th2 cells, or a primary skin barrier defect with immunological changes secondary to this, promoted by the invasion of trigger factors such as allergens and microbes …”

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confidence: 99%

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Contact allergy in children with atopic dermatitis: a systematic review

et al. 2017

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The importance of contact allergy in children with atopic dermatitis is frequently debated. Previously, patients with atopic dermatitis were believed to have a reduced ability to produce a type IV immunological response. However, this belief has been challenged and authors have highlighted the risk of underestimating and overlooking allergic contact dermatitis in children with atopic dermatitis. Several studies have been published aiming to shed light on this important question but results are contradictory. To provide an overview of the existing knowledge, we systematically reviewed studies that report frequencies of positive patch test reactions in children with atopic dermatitis. We identified 436 manuscripts of which 31 met the inclusion criteria. Although the literature is conflicting, it is evident that contact allergy is a common problem in children with atopic dermatitis.

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Section: What Does This Study Add?mentioning

confidence: 99%

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confidence: 99%

Contact allergy in children with atopic dermatitis: a systematic review

et al. 2017

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“…on the sides of the feet), if there is later onset of disease or new significant worsening, if there is no family history of atopy, and in those with persistent/recalcitrant disease not responding to standard AD therapies. 78, 79 Even some cases of generalized dermatitis may involve ACD, such as to fragrances, preservatives, cleansers, and textiles 80 , but are a challenge to recognize as well as to test if there is little uninvolved skin. The sensitivity of patch testing ranges from 60-80% in reports.…”

Section: Co-existing Allergic Disease and Allergy Testingmentioning

confidence: 99%

Guidelines of care for the management of atopic dermatitis

Sidbury

Tom

Bergman

et al. 2014

Journal of the American Academy of Dermatology

262

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“…2 Nos adultos, a frequência de testes epicutâneos positivos na população normal varia entre 10-27% da população, 3 mas a exata prevalência e incidência nas crianças é ainda desconhecida e difícil de quantificar. [4][5][6] Sendo uma causa frequente de eczema ou de agravamento de dermatoses pré-existentes, a DCA pode ter grande impacto a nível pessoal e socioeconómico bem como implicações na vida adulta e no futuro profissional destas crianças.…”

Section: Introductionunclassified

Dermatite de Contacto Alérgica em Idade Pediátrica: Estudo Retrospectivo

Cordeiro

Ramos

Gonçalo

2017

SPDV

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RESUMO -Introdução: A dermatite de contacto alérgica em idade pediátrica, habitualmente considerada pouco frequente, tem sido recentemente objecto de numerosas publicações associadas a um aparente aumento da sua prevalência. Tal pode ser devido a exposição e sensibilização mais precoce a alergénios de contacto ou à mais ampla utilização de testes epicutâneos, cruciais ao diagnóstico desta patologia. Métodos: Com o objectivo de avaliar as características e causas da dermatite de contacto alérgica em idade pediátrica, foram analisados os processos clínicos dos doentes com < 18 anos que efetuaram testes epicutâneos entre Janeiro de 2005 e Dezembro de 2014 na Unidade de Alergologia de Contacto do Serviço de Dermatologia dos HUC. Avaliaram--se os seguintes parâmetros: sexo, idade, história pessoal e familiar de atopia, localização principal da dermatose, testes positivos a alergénios da série básica ou outros e respectiva relevância, hipótese de diagnóstico e diagnóstico final. Resultados: Foram estudados 106 doentes em idade pediátrica (3,6% do total), 68 do sexo feminino (64,2%) e 38 do sexo masculino (35,8%), quatro com idades compreendidas entre os 3 e 5 anos (3,8%), 28 entre os 6 e 11 anos (26,4%) e 74 entre os 12 e 17 anos (69,8%), 52,8% com antecedentes de atopia e 36,8% com lesões localizadas na face e/ou pescoço. Dos 106 doentes, 51 tiveram pelo menos um teste positivo (48,1%), mais frequentemente no sexo feminino por alergia ao níquel (18,9%). Seguiram-se o cobalto, a p-fenilenodiamina e a mistura de caínas (4,7%) entre os alergénios de série básica e, fora dela, o paládio positivo em cinco crianças. De notar que não observámos testes positivos ao níquel nos últimos dois anos. Doze doentes reagiram apenas a alergé-nios não incluídos na série básica, sobretudo medicamentos. Discussão: A alergia de contacto e dermatite de contacto alérgica antes dos 18 anos revelaram-se relativamente comuns. O diagnóstico etiológico precoce é importante para evitar a cronicidade das lesões e prevenir possíveis repercussões futuras a nível pessoal e profissional. O conhecimento dos principais alergénios nesta faixa etária poderá orientar medidas preventivas de futuras sensibilizações. 3-5 years (3.8%), 28 between 6-11 years (26.4%) PALAVRAS-CHAVE -

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Contact Dermatitis in the Atopic Child

Abstract: Image courtesy of Sharon E. Jacob, MD. Reprinted with permission. Figure. Classically, allergic contact dermatitis presents as a pruritic, eczematous dermatitis typified by edematous vesicles and papules coalescing into plaques.

Cited by 8 publications

References 26 publications

Contact allergy in children with atopic dermatitis: a systematic review

Contact allergy in children with atopic dermatitis: a systematic review

Guidelines of care for the management of atopic dermatitis

Dermatite de Contacto Alérgica em Idade Pediátrica: Estudo Retrospectivo

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