Patch testing in children with hand eczema. A 5-year multicentre study in Spain

Fernando Toledo, Begoña García-Bravo, Virginia Fernández-Redondo, Jesús De la Cuadra, Ana María Giménez-Arnau, Leopoldo Borrego, José Manuel Carrascosa, José Carlos Armario-Hita, Paloma Sánchez-Pedreño, Marcos Hervella, Ricardo González, Juan Francisco Silvestre
Contact Dermatitis 2011, 65 (4): 213-9

BACKGROUND: Hand eczema is common in children, but affected children are seldom patch tested. Relatively few studies have assessed patch testing in the paediatric population, and none has specifically evaluated its use in hand eczema in children.

OBJECTIVES: The aim of this study was to determine the prevalence of contact allergy in children with hand eczema, and to identify the most frequent allergens and their relevance.

MATERIAL AND METHODS: We performed a 5-year retrospective study of children (aged 0-15 years) with hand eczema tested with the Spanish baseline series at the Dermatology Departments of 11 Spanish hospitals.

RESULTS: During the study period, 11 729 patients were patch tested, of whom 480 were children. Hand eczema was present in 111 (23.1%) of the children and in 3437 (30.5%) of the adults. Of the children with hand eczema, 46.8% had at least one positive reaction in the patch tests. Current relevance was found for 78% of the allergens detected. The most common allergens were nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I. Allergic contact dermatitis was the most frequent diagnosis (36%), followed by atopic dermatitis.

CONCLUSIONS: Allergic contact dermatitis was the most usual diagnosis in our series of children with hand eczema. We recommend patch testing of all children with chronic hand eczema, as is already performed in adults.

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