Allergic contact dermatitis in children: the Ottawa hospital patch-testing clinic experience, 1996 to 2006

Marcia Hogeling, Melanie Pratt
Dermatitis 2008, 19 (2): 86-9

BACKGROUND: Allergic contact dermatitis in children is a significant clinical problem. Patch testing is a diagnostic tool for the evaluation of patients with suspected allergic contact dermatitis.

OBJECTIVES: To determine the frequency and relevance of positive patch-test results in children and to identify the most common allergens in children at our clinic.

METHODS: Retrospective chart review of 100 children and adolescents, aged 4 to 18 years, who were patch-tested at the Ottawa Hospital patch-testing clinic between 1996 and 2006. The children were patch-tested with the North American Contact Dermatitis Group (NACDG) standard series, supplementary series if indicated, and their own products if available.

RESULTS: Seventy percent of children had at least one positive patch-test reaction; 55.8% of positive patch-test reactions were relevant. The ratio of females to males was 62:38. The most common allergens were nickel sulfate (26%), cobalt (14%), fragrance mix (7%), neomycin (7%), colophony (6%), formaldehyde (4%), lanolin (4%), quaternium-15 (4%), and para-phenylenediamine (4%). Nickel co-reacted with cobalt (68%) and palladium (100%). Of children tested, 41% had a history of atopic dermatitis.

CONCLUSIONS: The frequency of positive and relevant allergens in children is similar to that in adults as compared with data from the NACDG 2001-2002 study period. Differences between the top 10 allergens in children and adults were seen. Nickel and cobalt were more common allergens in children, and colophony, lanolin, and para-phenylenediamine ranked in the top 10 allergens among children.

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