Immediate‐ and Delayed‐Type Contact Hypersensitivity in Children Older than 5 Years With Atopic Dermatitis: A Pilot Study Comparing Different Tests

Oranje, Arnold P.; Bruynzeel, Derk P.; Stenveld, Harma J.; Dieges, P. H.

doi:10.1111/j.1525-1470.1994.tb00588.x

Cited by 37 publications

(17 citation statements)

References 17 publications

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“…Seventeen children (43%) showed a positive reaction to nickel sulphate, similar to that reported in earlier studies [1, 7, 11, 14, 15]. In a previous study in Rotterdam, the most positive patch test reactions in children aged 5–15 years were to nickel, cobalt and balsam of Peru [8]. However, in the study by Kohl et al [16], metals (predominantly nickel) were listed only in third place, behind cosmetics and topical drugs as the cause of ACD in children.…”

Section: Discussionsupporting

confidence: 75%

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Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Spek

Oranje²

2008

Dermatology

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Aims: The results of patch testing in children visiting our out-patient clinic with suspected allergic contact dermatitis (ACD) were prospectively investigated and compared with those reported in the literature. A review of the literature on patch testing and ACD in children is provided. Methods: Children were patch tested using the TRUE® test, supplemented with tixocortol-17-pivalate, budesonide and 3 commonly used emollients. Supplementary patch tests were undertaken on indication. Results: Seventy-nine children (31 boys and 48 girls) were patch tested. Of the patients tested, 40 (51%) had 1 or more positive allergic patch test reactions. Twenty-two (55%) of these 40 children suffered from atopic dermatitis, 9 (23%) from hand or foot dermatitis, and 9 (23%) from other skin ailments. Nickel was the most common contact allergen, but many other common and less common allergens were noted to give positive patch tests in patients. Conclusion: Sensitization to contact allergens may begin in infancy and continue to be more common in toddlers and young children. In recalcitrant atopic dermatitis, especially at the age of 5 years and over, patch tests are indicated. Good information on preventing the development of ACD in children is useful for caregivers.

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Section: Discussionsupporting

confidence: 75%

“…ACD was suspected in all patch-tested children. In an earlier prospective open study in 33 children with atopic dermatitis (aged 5–15 years), Oranje et al[ 8] reported 14 of 33 children with positive patch test reactions.…”

Section: Discussionmentioning

confidence: 99%

Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Spek

Oranje²

2008

Dermatology

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“…Cobalt chloride and potassium dichromate were also frequent sensitizers, as were fragrance markers (fragrance mix I, fragrance mix II, Myroxylon pereirae and hydroxyisohexyl‐3‐cyclohexenecarboxaldehyde) . When children with and without AD referred for patch testing were compared, the risks of sensitization to fragrance mix I and Myroxylon pereirae were significantly associated with AD (4·1% vs. 2·6%, P < 0·01; and 3·5% vs. 2·5%, P < 0·02, respectively).…”

Section: Resultsmentioning

confidence: 99%

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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“…Sensitizations to foods can be investigated by means of in vivo tests (skin prick tests, prick‐prick tests) and in vitro tests (serum specific IgE). A positive test will reflect sensitization, but may have poor correlation with clinical allergic responses . In addition, atopy patch tests proved to be useful for studying delayed food‐related skin responses …”

Section: Avoidance Strategies On the Basis Of Allergy Diagnosismentioning

confidence: 99%

ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients

Wollenberg

Oranje²,

Deleuran

et al. 2016

Acad Dermatol Venereol

358

488

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Atopic dermatitis (AD) is a clinically defined, highly pruritic, chronic inflammatory skin disease of children and adults. The diagnosis is made using evaluated clinical criteria. Disease activity is best measured with a composite score assessing both objective signs and subjective symptoms, such as SCORAD. The management of AD must consider the clinical and pathogenic variabilities of the disease and also target flare prevention. Basic therapy includes hydrating topical treatment, as well as avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment of visible skin lesions is based on topical glucocorticosteroids and the topical calcineurin inhibitors tacrolimus and pimecrolimus. Topical calcineurin inhibitors are preferred in sensitive locations. Tacrolimus and mid-potent steroids are proven for proactive therapy, which is long-term intermittent anti-inflammatory therapy of the frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is indicated for severe refractory cases. Biologicals targeting key mechanisms of the atopic immune response are promising emerging treatment options. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) may diminish pruritus, but do not have sufficient effect on lesions. Adjuvant therapy includes UV irradiation, preferably UVA1 or narrow-band UVB 311 nm. Dietary recommendations should be patient specific and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. 'Eczema school' educational programmes have been proven to be helpful for children and adults.

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Immediate‐ and Delayed‐Type Contact Hypersensitivity in Children Older than 5 Years With Atopic Dermatitis: A Pilot Study Comparing Different Tests

Cited by 37 publications

References 17 publications

Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Patch Tests in Children with Suspected Allergic Contact Dermatitis: A Prospective Study and Review of the Literature

Contact allergy in children with atopic dermatitis: a systematic review

ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients

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