Primary Irritant Patch-Test Reactions in Children

Marcussen, Poul V.

doi:10.1001/archderm.1963.01590150094017

Cited by 51 publications

(18 citation statements)

References 7 publications

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“…This opinion was based upon 2 concepts: 1) the reduced exposure to contact allergens in childhood and 2) the possibility that the immune system in children may be less susceptible to contact allergens (13,16). Furthermore, several authors assumed that the majority of positive reactions in children were irritant (14,(17)(18)(19)(20), and that this non-specific irritability of the skin is lost around the age of 8.…”

Section: Incidence and Prevalence Of Allergic Contact Dermatitis And mentioning

confidence: 99%

Allergic contact dermatitis in children and adolescents

1999

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From a clinical point of view, the prevalence of allergic contact dermatitis (ACD) among children and adolescents seems to be low. However, many children have dermatitis, most often atopic dermatitis. In selected cases, ACD is suspected, and the child is tested. The question remains, whether the prevalence of ACD in children really is low or whether the possibility of ACD is not sufficiently considered. During the last decade, reports have appeared on series of children and adolescents with contact allergy and ACD. Few cases have been reported in infants, but the development of contact allergy and ACD increases with age. Most studies include selected groups of children and adolescents with suspected ACD. Few studies have examined unselected populations, and most consider only the prevalence of contact allergy without evaluating the clinical relevance, e.g., the prevalence of ACD. Furthermore, no follow-up studies exist. Therefore, the incidence and prevalence of contact allergy and ACD in children and adolescents is largely unknown.Key words: allergic contact dermatitis; contact allergy; Type IV allergy; patch testing; allergens; clinical relevance; children; adolescents; epidemiology; incidence; prevalence; atopic dermatitis; IgE-mediated hypersensitivity; Type I allergy. C Munksgaard, 1999. Accepted for publication 1 April 1999Allergic contact dermatitis (ACD) in children and adolescents is seen occasionally, and several reports on series of children and adolescents with ACD have appeared in the literature (1-7). The frequency of unselected children and adolescents with positive patch tests to standard series allergens is not negligible (8-10). About 8% of unselected adolescents are nickel allergic and about 2% react to fragrance mix (11). When the contact allergy develops, and what the consequences of a positive patch test result are for the individual child, is less clear. This review summarizes the current knowledge from an epidemiological and clinical point of view. Epidemiology Definitions and study designsThere are many definitions of epidemiology: one of the clearest is the study of occurrence of illness (12). The frequency of ACD can be expressed in terms of its incidence (the number of new cases of ACD during a defined period in a specific population) or its prevalence (the number of persons in the population with ACD at a certain point in time or during a certain period of time).The 3 most important types of observational study in the epidemiology of ACD are follow-up (cohort) studies, case-control studies and crosssectional studies.(i) In follow-up studies, selection of subjects is based upon exposure to factors of interest. In the prospective follow-up study, the person is exposed but free of the disease at the beginning of the study and is followed over a certain period of time. When both exposure and disease are historical, the study is described as a retrospective follow-up study. This design is less expensive than the prospective study. The measurement in follow-up studies is incidence.(ii) In ...

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Section: Incidence and Prevalence Of Allergic Contact Dermatitis And mentioning

confidence: 99%

Allergic contact dermatitis in children and adolescents

1999

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“…No conclusion can be drawn from this small study. It is known that the skin of children is more easily irritated than that of adults [7], All our cases of kerosine dermatitis were children. In addition to greater irritability, children are less aware of the hazard wearing kerosine-soaked clothing.…”

Section: Effect O F Agingmentioning

confidence: 67%

Kerosine Dermatitis

Tagami

Ogino²

1973

Dermatology

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In four children, dermatitis developed following contact with kerosine-soaked clothing. Experimental reproduction of the disease was achieved in volunteer subjects by application of kerosine, supporting the view that kerosine dermatitis is of primary irritant type. Studies on the physical factors related to the skin irritability to kerosine demonstrated the following facts: (1) The skin of the Negroes appeared to be less irritable to kerosine than that of Caucasians; (2) the influence of aging is not clear, (3) no definite correlation was noted between the individual cutaneous response to kerosine and permeability of the horny layer measured by TCSA penetration time; (4) the blood circulation seems to be influencial in the skin irritability to kerosine, and the low irritability of the forehead can be explained by the richness of the dermal vasculature.

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“…Contact allergy has traditionally been considered to occur rarely in the paediatric population, mainly as a result of the lesser exposure to allergens [1][2][3]. The prevalence of contact allergy in children has over the last decades increased as a result of the more grownup behavior of children (e.g., body piercing, hair dyeing, and use of cosmetics) and more extensive patch testing of children with contact dermatitis [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…PPD is a known strong sensitizer and has for centuries been known to cause contact allergy [2,7,[10][11][12][13][14], which may sensitize by a single or few exposures depending on the exposure concentrations.…”

Section: Introductionmentioning

confidence: 99%

p-Phenylenediamine and Risk of Sensitization in Children

Schwensen

Johansen

2014

Curr Treat Options Allergy

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Opinion statementContact allergy to p-phenylenediamine (PPD) in children has been described over almost 2 decades, indicating a major problem. PPD can be found in permanent hair dyes and temporary henna tattoos. Children often get sensitized to PPD at a relatively young age when getting a temporary henna tattoo while away on holiday in exotic surroundings. This results in a localized acute allergic reaction at the site of the tattoo within 1-2 weeks after the tattoo has been drawn. The symptoms will clear over weeks on treatment with topical corticosteroids. However, sensitization to PPD will be life-long and may later result in very severe allergic reactions if re-exposure to PPD happens, e.g., by hair dyeing. Populationbased studies indicate that even young children may get their hair dyed and that many teenage girls dye their hair regularly. Exposure to permanent hair dyes with PPD and related substances may in itself lead to PPD sensitization and severe allergic reactions. The allergic reaction will typically develop within hours after dyeing the hair, with clinical presented symptoms such as facial edema and facial dermatitis, which also may generalize. This may lead to hospital admission and treatment with systemic corticosteroids. It is important to note that this is a delayed-type hypersensitivity reaction and should be treated as such. Antihistamines have no effect in this situation. PPD sensitization may have long-term carrier consequences, as, for example, PPD contact allergy in a teenage girl may hinder her entering the hairdressing trade. Patch testing is used to make the diagnosis of PPD sensitization. In children with severe clinical reactions to temporary henna tattoos and/or permanent hair dyes, it is advisable to start the patch testing with PPD in a low concentration, e.g., 0.01 % PPD in petrolatum. It is not recommended to get temporary henna tattoos under any circumstances and children under the age of 16 years should not use permanent hair dyes in order to avoid severe allergic reactions and life-long sensitization to PPD.

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Primary Irritant Patch-Test Reactions in Children

Cited by 51 publications

References 7 publications

Allergic contact dermatitis in children and adolescents

Allergic contact dermatitis in children and adolescents

Kerosine Dermatitis

p-Phenylenediamine and Risk of Sensitization in Children

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