Contact Sensitization in Children: A Retrospective Study of 2,614 Children from a Single Center

Fortina, Anna Belloni; Fontana, Elena; Peserico, Andrea

doi:10.1111/pde.12873

Cited by 50 publications

(55 citation statements)

References 26 publications

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“…As the presence of these surfactants is frequent in daily cosmetic products (shampoo, liquid soap, toothpaste), sensitization to the agents could easily occur. High prevalences of CAPB/DMAPA contact allergies have been found by other authors as well, but are underreported as they are often not tested, as they are not in the EBS and only tested on indication 25, 48, 49. The allergenic potential of CAPB has been disputed, and it is argued whether CAPD is a true allergen or only an irritant 50.…”

Section: Discussionmentioning

confidence: 96%

“…A large multicentre study in Dutch children showed that children with AD were significantly more often sensitized to fragrances and wool alcohols 21. Also, potassium dichromate, disperse blue 106 and compositae mix are frequent sensitizers 25. If corticosteroid therapy is not sufficient for treating AD anymore, many dermatologists may suspect an allergy for corticosteroids 24, 26, 27…”

Section: Introductionmentioning

confidence: 99%

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Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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BackgroundConcomitant allergic contact dermatitis (ACD) has been described as a possible cause of atopic dermatitis (AD) becoming difficult‐to‐treat. However, contact sensitization in this patient group has barely been studied.ObjectiveTo study the occurrence of ACD in a population of difficult‐to‐treat AD children and adults.MethodsClinical and patch test information of 48 patients with difficult‐to‐treat AD unresponsive to conventional outpatient treatments was gathered retrospectively. We studied prevalence and relevance of common allergens, performed dynamic patch test analysis and assessed occurrence of polysensitization.ResultsIn 48 patients with difficult‐to‐treat AD, 75% (n = 36/48) had a concomitant contact allergy, and 39% (n = 14/36) of these patients were polysensitized. ACD and polysensitization prevalences were equal amongst children and adults. The most frequent and relevant reactions were seen against wool alcohols, surfactants cocamidopropyl betaine and dimethylaminopropylamine, bichromate and fragrance mix I. Dynamic pattern analysis showed these reactions to be mostly allergic and not irritative of nature.ConclusionDifficult‐to‐treat AD patients frequently suffer from concomitant (multiple) contact allergies, and this may be a reason why the AD turns into a difficult‐to‐treat disease. Awareness of this phenomenon is necessary, as pragmatic implementation of allergen avoidance strategies may be helpful in getting disease control in this population.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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“…Cobalt was the second most common allergen. Authors of recent studies on allergic contact dermatitis in children have reported similar high frequencies of positive patch test reactions to this allergen . Cobalt allergy is currently a “hot topic”, as it is increasingly being recognized as an independent sensitizer, and new sources of exposure have to come to light .…”

Section: Discussionmentioning

confidence: 97%

“…33,34 In the present study, the overall sensitization prevalence was the same among children with atopic dermatitis as among children without atopic dermatitis, in agreement with recent similar studies. 5,35,36 However, there is an inherent risk of selection bias in retrospective studies of patients referred for patch testing: As children were patch tested because of either recalcitrant eczema or a clinical suspicion of allergic contact dermatitis, it could be that children without atopic dermatitis were more carefully selected for patch testing, that is, there was a strong suspicion of allergic contact dermatitis, whereas children with atopic dermatitis may be referred for patch testing because of aggravation of the atopic dermatitis. This could lead to an underestimation of the prevalence of contact allergy among children with atopic dermatitis.…”

Section: Discussionmentioning

confidence: 99%

Contact allergy in Danish children: Current trends

et al. 2018

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“…The prevalence of positive reactions is typically lower than that seen with Compositae mix 6% pet. : the mean prevalence of positive reactions in a multicentre study of 2818 Swedish patients was 1.1%, and, likewise, an Italian study of 2614 children aged <11 years old reported a prevalence of positive reactions of 1.6%. Compositae mix 5% pet.…”

Section: Discussionmentioning

confidence: 99%

Screening for Compositae contact sensitization with sesquiterpene lactones and Compositae mix 2.5% pet

Paulsen

Andersen

2019

Contact Dermatitis

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Background: Compositae contact sensitization may be difficult to diagnose, because of a lack of reliable screening allergens.Objectives: To assess the suitability of Compositae mix II 2.5% pet. (CM2.5) as a screening mix in the baseline series combined with sesquiterpene lactone (SL) mix and parthenolide (PTH).Methods: CM2.5 was added to the baseline series, which included SL mix and PTH 0.1% pet., in January 2015, and PTH was included in TRUE Test Panel 3 in October 2015. All Compositae-sensitive patients diagnosed or tested in the next 4 years were assessed.Results: Altogether, 57 patients (2.7%) presented with Compositae allergy. On primary testing in 53 newly diagnosed patients, SL mix elicited positive reactions most frequently (53% positive), followed by CM2.5 (47% positive), and PTH (45% positive).CM2.5 and PTH pet. elicited a few irritant reactions. Three patients had late reactions. Altogether, 16 patients (28%) were not detected by any of the three screening agents.Conclusions: SL mix is an indispensable, although insufficient, screening mixture in Denmark. It may be relatively safely supplemented with CM2.5 and PTH in the TRUE Test system for screening, but, when Compositae sensitization is suspected, further extracts should be tested on the basis of the history. K E Y W O R D Sallergic contact dermatitis, Asteraceae, baseline series, Compositae mix II 2.5%, Compositae mix II 5%, parthenolide, patch testing, sesquiterpene lactone mix

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Contact Sensitization in Children: A Retrospective Study of 2,614 Children from a Single Center

Cited by 50 publications

References 26 publications

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Contact allergy in Danish children: Current trends

Screening for Compositae contact sensitization with sesquiterpene lactones and Compositae mix 2.5% pet

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