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Patch tests in children with suspected allergic contact dermatitis: a prospective study and review of the literature

Flora B de Waard-van der Spek, Arnold P Oranje
Dermatology: International Journal for Clinical and Investigative Dermatology 2009, 218 (2): 119-25
18946202

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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