Patch Tests in Children: A Review of 13 Years of Experience in Comparison with Previous Data

Abstract

The true prevalence of allergic contact dermatitis (ACD) in children remains unknown. Our aim was to compare the results of patch tests in children with suspected ACD between two different periods of time and identify possible changes in emerging allergens. We compared contact allergens, gender, age distribution, and personal history of atopic dermatitis (AD), in correlation with the positivity of patch tests, between two equal periods of time (232 children tested during 1980-1993, period A, and 255 children during 1994-2007, period B) in the same region and in the same institution. Patch test positivity was 47.8% in period A, and 60% in period B (p = 0.083). The most common allergens in period A were: nickel sulfate (16.3%), cobalt chloride (8.6%), fragrance mix (7.3%), potassium dichromate (4.3%), and thimerosal only (1.7%). In period B, the allergen distribution was as follows: nickel sulfate (21.56%), thimerosal (18.03%), cobalt chloride (12.9%), potassium dichromate (9.4%), and fragrance mix (4.7%). Girls were more likely to have a positive patch test compared with boys, with reactions in 53% of girls and 39% of boys in period A (p = 0.003), and 61% of girls and 58% of boys in period B (p = 0.691). Twenty-nine per cent of patients with positive results had a personal history of AD in period A and 44% in period B (p = 0.015). Differences in the positivity of allergens between different time periods reflect changes in habits, of allergens exposure or preventive measures.

Dermatite de Contacto Alérgica em Idade Pediátrica: Estudo Retrospectivo

“…4,12,13 É ainda controverso se os doentes com atopia têm maior ou menor propensão para DCA. 15,17 Neste estudo, a positividade dos testes epicutâneos é maior nos doentes com atopia pessoal (55,4%) o que pode sugerir que estes doentes podem ter um risco aumentado de desenvolver DCA ou maior exposição a medicamentos tópicos e emolientes, sobretudo no caso do eczema atópico.…”

Allergic Contact Dermatitis in Children

“…Some authors have indicated that ACD is less prevalent in patients with AD (Uhr, 1960;Rystedt, 1985;De Groot, 1990;Katsarou et al, 1996;Stables et al, 1996;Brasch & Geier, 1997). Several authors were unable to detect differences between atopic and nonatopic subjects in this regard (Marghescu, 1985;Pambor et al, 1991;Goossens et al, 1995;Akhavan & Cohen, 2003;Beattie et al, 2007;Milingou et al, 2010). Against this others have even found a greater prevalence of ACD in patients with AD (De la Cuadra et al, 1990;Lammintausta et al, 1992;Dotterund & Falk, 1995;Lugovic & Lipozencic, 1997;Giordano-Labadie et al, 1999;Clayton et al, 2006).…”

“…The widespread use as a preservative in a variety of compounds, including vaccine and antitoxin preparations, ophthalmic drops and contact lens solutions, www.intechopen.com may explain the high rate of positive patch test reactions (Katsarou et al, 1996;Militello et al, 2006;Goossens & Morren, 2006;Milingou et al, 2010). Low clinical relevance along with sensitization rates is probably related to its presence in vaccines (Novák et al, 1986;Osawa et al, 1991;Lee et al, 2009).…”

“…Even in younger children nickel allergy is not uncommon (Jøhnke et al, 2004). Published rates of nickel sensitization in children range between 10% and 24% (Wöhrl et al, 2003;Heine et al, 2004;Lewis et al, 2004;Seidenari et al, 2005;Vozmediano & Hita, 2005;Clayton et al, 2006;Militello et al, 2006;Goossens & Morren, 2006;Milingou et al, 2010). Ear piercing along with atopy is regarded as a major risk factor for the development of nickel sensitization, especially in girls (Militello et al, 2006;Goossens & Morren, 2006).…”

Contact Dermatitis in Children

“…Symptomatic children frequently exhibit positive patch testing to fragrances, as elucidated by several recent studies (Clayton et al, 2006;Hogeling & Pratt, 2008;Milingou et al, 2010;Zug et al, 2010). A particularly important diagnostic tool is the 'Fragrance Mix' patch test, which contains three cinnamic derivatives, two eugenol derivatives, geraniol, hydroxycitronellal and oak moss absolute extract.…”