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Wang C, Gu W, Zhang S, Li L, Kong J, Zhi H, Liu J, Wang M, Miao K, Li Q, Yu J, Wang R, He R, Zhang S, Deng F, Duan S, Zhang Q, Liu Z, Yang H, Jia X, Peng H, Tang S. Multigenerational effects of disperse blue 79 at environmentally relevant concentrations on zebrafish (Danio rerio) fecundity: An integrated approach. JOURNAL OF HAZARDOUS MATERIALS 2024; 478:135442. [PMID: 39128150 DOI: 10.1016/j.jhazmat.2024.135442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024]
Abstract
The brominated azo dye (BAD) Disperse Blue (DB79) is a widespread environmental pollutant. The long-term toxicological effects of DB79 and the mechanisms thereof must be understood to allow assessment of the risks of DB79 pollution. A dual-omics approach employing in silico analysis, bioinformatics, and in vitro bioassays was used to investigate the transgenerational (F0-F2) toxicity of DB79 in zebrafish at environmentally relevant concentrations and identify molecular initiating events and key events associated with DB79-induced fertility disorders. Exposure to 500 µg/L DB79 decreased fecundity in the F0 and F1 generations by > 30 % and increased the condition factor of the F1 generation 1.24-fold. PPARα/RXR and PXR ligand binding activation were found to be critical molecular initiating events associated with the decrease in fecundity. Several key events (changes in fatty acid oxidation and uptake, lipoprotein metabolism, and xenobiotic metabolism and transport) involved in lipid dysregulation and xenobiotic disposition were found to be induced by DB79 through bioinformatic annotation using dual-omics data. The biomolecular underpinnings of decreased transgenerational fertility in zebrafish attributable to BAD exposure were elucidated and novel biomolecular targets in the adverse outcome pathway framework were identified. These results will inform future studies and facilitate the development of mitigation strategies.
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Affiliation(s)
- Chao Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen Gu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaoping Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jian Kong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hong Zhi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengmeng Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ke Miao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Li
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Jie Yu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Runming Wang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Runming He
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuyi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuchang Deng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuling Duan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiannan Zhang
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Sciences Research Unit, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhenming Liu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Hui Yang
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Sciences Research Unit, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Xudong Jia
- National Health Commission Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Sciences Research Unit, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Hui Peng
- Department of Chemistry, School of Environment, University of Toronto, Toronto, Ontario, Canada
| | - Song Tang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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Sandler M, Chen LC, Yu J. The Impact of Systemic Immunomodulating Therapies on Patch Testing Results in Children: A Retrospective Cohort Study. Dermatitis 2024. [PMID: 38973753 DOI: 10.1089/derm.2023.0414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Affiliation(s)
- Mykayla Sandler
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Li-Chi Chen
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Brumley C, Arora P, Hylwa SA. Characterization of Pediatric Patch Testing: A Retrospective Review, 2020-2023. Dermatitis 2024. [PMID: 38913333 DOI: 10.1089/derm.2024.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Background: Recent evidence shows similar rates of allergic contact dermatitis (ACD) among children and adults despite children accounting for less than 10% of patch testing subjects. With a need for in-depth analyses of pediatric ACD, we herein characterize a pediatric cohort at a large North American patch testing center. Methods: A retrospective chart review was conducted for 135 patients ages 1-17 years who underwent patch testing from July 2020 from August 2023. Data were stratified by age 1-5, 6-11, and 12-17 years. Significance-Prevalence Index Numbers (SPIN) were calculated. Results: A total of 86% were sensitized, 40% had a relevant reaction, and positivity rates were equal between males and females. Top allergens by SPIN differed with age, but overall were linalool hydroperoxides (SPIN = 11.01), propylene glycol (10.30), limonene hydroperoxides (10.27), fragrance mix I (5.62), and lanolin (4.90). In total, 14% of the top allergens were not represented on the North American Contact Dermatitis Group standard series. Of those tested to personal products, 45% had positive reactions and 72% of which were relevant. Conclusions: Emulsifiers and fragrances were the most relevant allergen categories, with the impact of emulsifiers not previously reported. ACD may affect males and females equally in this population. Supplemental allergens and personal products tested "as-is" contribute to conclusive pediatric patch testing.
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Affiliation(s)
- Caroline Brumley
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Puneet Arora
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Sara A Hylwa
- From the Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
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Handa S, Bhattacharjee R, Thakur V, De D, Mahajan R. Contact hypersensitivity to Indian standard patch test series correlates with disease severity among children with atopic dermatitis. Indian J Dermatol Venereol Leprol 2024; 90:46-51. [PMID: 37609746 DOI: 10.25259/ijdvl_492_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 05/15/2023] [Indexed: 08/24/2023]
Abstract
Background There is emerging evidence of a relationship between atopic dermatitis (AD) and allergic contact dermatitis (ACD), though the data available are scarce with conflicting viewpoints. We explored the occurrence of contact hypersensitivity among children with atopic dermatitis by patch testing them with the Indian standard series and tried to correlate the presence of contact hypersensitivity with the clinical severity of AD in these children. Methods In this single-centre, cross-sectional study, children between 6 months and 12 years diagnosed with atopic dermatitis were included and patch tested with the Indian standard series. Outcome parameters were the proportion of patients having positive patch-test reactions, the proportion of positive patch-test reactions for each allergen and factors associated with patch test positivity in atopic dermatitis. Results Of the 136 patients, 80 were boys. The mean age of the study population was 5.6 ± 3.2 years. Twenty-eight (20.6%) patients had patch test positivity at 96 h. Fragrance mix was the commonest allergen, followed by potassium dichromate, cobalt chloride hexahydrate and nickel. SCORing atopic dermatitis (SCORAD) was significantly higher in patients with positive patch tests as compared to patients with negative patch tests (P = 0.009). Conclusion Greater disease severity in atopic dermatitis was found to be associated with patch test positivity. Limitations Inability to establish relevance in about 50% of the patients was a limitation of our study. Follow-up data regarding the impact of allergen avoidance is not available.
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Affiliation(s)
- Sanjeev Handa
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Rajsmita Bhattacharjee
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vishal Thakur
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Johnson H, Aquino MR, Snyder A, Collis RW, Franca K, Goldenberg A, Sui JY, Eichenfield DZ, Kozy BJ, Chen JK, Shope C, Goldminz AM, Yu J. Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case-control study. J Am Acad Dermatol 2023; 89:1007-1014. [PMID: 37768237 DOI: 10.1016/j.jaad.2023.06.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND As both allergic contact dermatitis and atopic dermatitis (AD) have similar clinical presentations and are characterized by spongiotic dermatitis on skin biopsy, many children with AD are not referred for patch testing and allergic contact dermatitis is underdiagnosed. OBJECTIVE To provide updated prevalence data of common contact allergens in children with and without AD. METHODS This is a retrospective case-control study using the Pediatric Allergic Contact Dermatitis Registry from 2018 to 2022. RESULTS A total of 912 children were included (615 with AD and 297 without AD). Children with AD were more likely to have a longer history of dermatitis (4.1 vs 1.6 years, P < .0001), have seen more providers (2.3 vs 2.1, P = .003), have greater than 1 positive patch test (PPT) result (P = .005), have a greater number of PPT results overall (2.3 vs 1.9, P = .012), and have a more generalized distribution of dermatitis (P = .001). PPT to bacitracin (P = .030), carba mix (P = .025), and cocamidopropyl betaine (P = .0007) were significantly increased in children with AD compared to those without AD. LIMITATIONS Technical variation between providers and potential for misclassification, selection, and recall biases. CONCLUSION Children with AD are significantly more likely to have PPT reactions and should be referred for evaluation of allergic contact dermatitis and obtain patch testing.
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Affiliation(s)
- Hadley Johnson
- School of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota; Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marcella R Aquino
- Department of Pediatrics, Division of Allergy & Immunology, Hasbro Children's Hospital, Providence, Rhode Island; Division of Allergy & Immunology, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alan Snyder
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina
| | - Reid W Collis
- Department of Dermatology, Washington University School of Medicine, St. Louis, Missouri
| | - Katlein Franca
- Dr Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alina Goldenberg
- Dermatologist Medical Group of North County, San Diego, California; Department of Medicine, University of California San Diego, San Diego, California
| | - Jennifer Y Sui
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California; Department of Dermatology, UC San Diego, La Jolla, California
| | - Dawn Z Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California; Department of Dermatology, UC San Diego, La Jolla, California
| | - Brittany J Kozy
- Division of Pediatric Dermatology, Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer K Chen
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Chelsea Shope
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina
| | - Ari M Goldminz
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Slodownik D, Bar J, Solomon M, Lavy Y, Baum S, Mordechai Galed O, Cnaan R, Solomon-Cohen E, Horev L, Daniely D. Pediatric Contact Dermatitis: A 10-Year Multicenter Retrospective Study. Dermatitis 2023; 34:399-404. [PMID: 37192492 DOI: 10.1089/derm.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Background: Although allergic contact dermatitis (ACD) is relatively common in the adult and pediatric populations alike, few studies describe the special features of contact sensitization among the Israeli pediatric populations, none of them is multicenter. Our study aims to describe and analyze patch test results and trends in 4 tertiary care centers between 2012 and 2022. Methods: We assessed the results of 357 patch tests performed on children 0-18 years old between 2012 and 2022 in designated clinics in 4 tertiary medical centers. All patients were tested using the European baseline series and additional series as clinically indicated. We assessed the demographic features, atopic features, and influence, as well as the main allergens to cause sensitization and allergic contact dermatitis among the pediatric population. Results: In total 69% of the study population were females, mainly 12-18 years old, 35% of the study population were previously diagnosed with atopic dermatitis, and 57% had an atopic diathesis. Females were more commonly sensitized (P < 0.05). Patients without atopic dermatitis were more commonly diagnosed with ACD and had more reactions on patch test (P < 0.05). The most common allergens to cause ACD are preservatives and metals, as previously described, however, acrylate sensitivity is an emerging group that has not been described among the Israeli pediatric population in previous studies. Fragrance mix 2 and Mroxylon pereirae are relatively rare allergens among the Israeli pediatric population, whereas linalool hyperoxide might be considered an emerging allergen. Methylisothiazolinone causes ACD more frequently among patients without atopic dermatitis (P < 0.05). Conclusions: Among the Israeli pediatric population, ACD is more common in females without atopic dermatitis. Acrylates become a common culprit and should be included in baseline series. Patients with atopic dermatitis are less frequently sensitized by methylisothiazolinone.
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Affiliation(s)
- Dan Slodownik
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Solomon
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Yaron Lavy
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Sharon Baum
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Roten Cnaan
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Liran Horev
- Department of Dermatology, Hadassah University Medical Center, Jerusalem, Israel; and
- Shamir Medical Center, Zerifin, Israel
| | - Danny Daniely
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Docampo-Simón A, Sánchez-Pujol MJ, Pastor-Nieto MA, Giménez-Arnau A, Rodríguez-Serna M, Serra-Baldrich E, Miquel J, Sánchez-Pérez J, Sanz-Sánchez T, Zaragoza-Ninet V, Sánchez-Pedreño P, Carrascosa JM, Gatica-Ortega ME, Fernández-Redondo V, Córdoba-Guijarro S, González-Pérez R, Silvestre JF. Patch Testing in Patients With Severe Atopic Dermatitis Treated With Dupilumab: A Multicentric Approach in Spain. Dermatitis 2023; 34:315-322. [PMID: 37001174 DOI: 10.1089/derm.2022.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background: Persistent localized dermatitis (PLD) or eczema flare-ups (EF) may occur in atopic dermatitis (AD) patients treated with dupilumab. They may reflect concomitant allergic contact dermatitis (ACD) exposed by the inhibition of the Th2 pathway by dupilumab in some cases. Objective: To evaluate the prevalence and etiology of these events and the impact of dupilumab on patch test outcome. Methods: We performed patch tests on 54 AD patients treated with dupilumab and evaluated the prevalence and final diagnosis of EF and PLD as well as the patch test results. Results: The patch test results were positive in 20/54 (37.0%). 21/54 patients (38.9%) had PLD and 12/54 (22.2%) had EF. Ten of 54 (18.5%) had both conditions and 11/54 (20.4%) had neither PLD nor EF. 64.5% of PLD involved the face. 83.9% patients with PLD and 90.9% patients with EF were diagnosed with inadequately controlled AD. 9.7% patients with PLD and 4.5% patients with EF were finally diagnosed with ACD. Nine of 21 (42.9%) patients patch tested twice were positive either before and/or during dupilumab. Patch tests results changed over time in all of them. Conclusions: Patch testing assisted us to exclude ACD as the cause of PLD/EF in AD patients treated with dupilumab. Most PLD and EF were, however, diagnosed as poorly controlled AD. Dupilumab appeared to impact the patch test outcomes.
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Affiliation(s)
- Alexandre Docampo-Simón
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - María J Sánchez-Pujol
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Maria A Pastor-Nieto
- Dermatology Department, Hospital General Universitario de Guadalajara, Faculty of Medicine and Health Sciences, Medicine and Medical Specialties Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ana Giménez-Arnau
- Dermatology Department, Hospital del Mar, Institut Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Javier Miquel
- Dermatology Department, Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | | | | | | | - Paloma Sánchez-Pedreño
- Dermatology Department, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Jose M Carrascosa
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Maria E Gatica-Ortega
- Dermatology Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Virginia Fernández-Redondo
- Dermatology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Juan F Silvestre
- From the Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
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Amat-Samaranch V, Silvestre Salvador JF. [Translated article] Haptens, Proteins, and Atopic Dermatitis. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T308-T317. [PMID: 36848955 DOI: 10.1016/j.ad.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/15/2022] [Indexed: 02/27/2023] Open
Abstract
Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by TH1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances.
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Affiliation(s)
- V Amat-Samaranch
- Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, Spain.
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9
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Amat-Samaranch V, Silvestre Salvador JF. Haptens, Proteins, and Atopic Dermatitis. ACTAS DERMO-SIFILIOGRAFICAS 2022; 114:308-317. [PMID: 36529271 DOI: 10.1016/j.ad.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/16/2022] Open
Abstract
Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by TH1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances.
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Affiliation(s)
- V Amat-Samaranch
- Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España.
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10
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Contact Sensitization in Pediatric Population With Atopic Dermatitis: A Retrospective Study of 80 Patients. Dermatitis 2022; 33:S114-S118. [DOI: 10.1097/der.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Silverberg JI, Patel N, Warshaw EM, Maibach HI, Belsito DV, DeKoven JG, Zug KA, Taylor JS, Sasseville D, DeLeo VA, Pratt MD, Reeder MJ, Atwater AR, Fowler JF, Houle MC. Patch testing with Cobalt in Children and Adolescents: North American Contact Dermatitis Group experience, 2001 to 2018. Contact Dermatitis 2022; 87:420-429. [PMID: 35801686 DOI: 10.1111/cod.14185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/12/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) to cobalt is more common in children and adolescents than adults. However, detailed information on sites and sources of cobalt ACD are limited. OBJECTIVES To assess trends in positive and clinically relevant patch test reactions to cobalt in children and associated patient characteristics, common sources, and body sites affected. METHODS A retrospective analysis of children (<18 years) patch tested to cobalt by the North American Contact Dermatitis Group between 2001-2018. RESULTS Of 1,919 children patch tested, 228 (11.9%) and 127 (6.6%) had a positive/allergic or currently relevant patch test reaction to cobalt, respectively. The most common primary body sites affected were scattered generalized (30.0%), face, not otherwise specified (NOS, 10.6%), and trunk (10.1%). Patients with allergic and currently relevant allergic patch test reactions were more likely to have a primary site of trunk (P=.0160 and P=.0008) ears (P=.0005 and P<.0001). Affected body site(s) varied by cobalt source among patients with currently relevant reactions, especially for less common sources. The most commonly identified sources of cobalt included jewelry, belts, and clothing. CONCLUSIONS Positive patch test reactions to cobalt were common in children. Most common body site was scattered generalized and the sources of cobalt varied by body site. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington D.C., USA; Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nisha Patel
- Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, MN.,Department of Dermatology, University of Minnesota, Minneapolis, MN.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, CA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ontario, Canada
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, NC
| | | | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire (CHU) de Québec, Laval University, Quebec, Canada
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Cattani CAS, Oppermann K, Perazzoli S, Guarda NH, Baréa P, Bonamigo RR. Sensitizing agents found in children and adolescents with recalcitrant atopic dermatitis: a cross-sectional study with a pediatric battery. An Bras Dermatol 2022; 97:307-314. [PMID: 35241316 PMCID: PMC9133262 DOI: 10.1016/j.abd.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Atopic dermatitis is the most common inflammatory skin disease in childhood and has an important impact on quality of life, especially severe cases or those that are recalcitrant to treatments. Sensitization to allergens with the potential for allergic contact dermatitis is a factor associated with cases of recalcitrant atopic dermatitis. Understanding the relationship between atopic dermatitis, allergens, and allergic contact dermatitis is essential. In Brazil, there are no studies on sensitization to allergens found in patch tests with pediatric batteries in patients with atopic dermatitis. OBJECTIVES To verify the main sensitizing agents, the prevalence of allergic contact dermatitis and the epidemiological and clinical profile of children and adolescents with atopic dermatitis. METHODS Cross-sectional, prospective study in patients between 4 and 18 years of age, with recalcitrant atopic dermatitis, treated at the Sanitary Dermatology Outpatient Clinic (RS). All patients underwent patch tests with a battery of pediatric allergens. RESULTS The prevalence of sensitization and allergic contact dermatitis in the evaluated patients was 37.07% (20/54) and 27.7% (15/54), respectively. The most frequent allergens were: nickel sulfate (16.7%), disperse blue (5.6%), and fragrance mix I (5.6%). Nickel was associated with the female sex (p = 0.019). STUDY LIMITATIONS Sample size and selection, absence of a control group. CONCLUSIONS A proportion of patients with recalcitrant atopic dermatitis may be sensitized to different allergens and may even have developed allergic contact dermatitis. Recognizing this context is important in the prevention strategy and management of the disease.
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Affiliation(s)
- Cristiane Almeida Soares Cattani
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil; Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Kenselyn Oppermann
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Simone Perazzoli
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nathalia Hoffmann Guarda
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Paula Baréa
- Sanitary Dermatology Outpatient Clinic, Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renan Rangel Bonamigo
- Postgraduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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13
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Bonamonte D, Hansel K, Romita P, Belloni Fortina A, Girolomoni G, Fabbrocini G, Patruno C, Napolitano M, Patrizi A, Argenziano G, Micali G, Pinton PC, Foti C, Stingeni L. Contact allergy in children with and without atopic dermatitis: an Italian multicenter study. Contact Dermatitis 2022; 87:265-272. [PMID: 35451136 PMCID: PMC9541036 DOI: 10.1111/cod.14130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
Background Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell‐mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results. Objectives The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD. Materials and methods A retrospective multicentre study on children aged from 0 to 14 years patch tested between January 2017 and December 2018 was performed. Children were consecutively patch tested with the SIDAPA (Società Italiana Dermatologia Allergologica Professionale Ambientale) baseline series. Results Among the 432 children investigated for contact allergy, 125 (28.9%) showed a positive reaction to at least one of the allergens tested, with a higher prevalence of positive patch test reactions in girls (32.3%) than in boys (25.0%). The most frequent contact allergens were nickel sulphate (10.2%), cobalt chloride (6.7%), methylisothiazolinone (3.7%), fragrance mix‐2 (3.2%), potassium dichromate (2.8%), fragrance mix‐1 (2.1%) and methylchloroisothiazolinone/methylisothiazolinone (2.1%). One‐hundred‐three children (23.8%) suffered from AD showing a higher prevalence of positive patch test (36.9%) compared to children without AD (26.4%). Conclusions Despite the topic being still controversial, the present study suggests a consistent prevalence of contact allergy among children with higher sensitivity rate among children with AD than without AD.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Anna Belloni Fortina
- Unit of Pediatric Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, IRCS Azienda Ospedaliero Universitaria, University of Bologna, Bologna, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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14
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Dupuy E, Miller M, Harter N. What We Have Learned–Milestones in Pediatric Contact Dermatitis. CURRENT DERMATOLOGY REPORTS 2022; 11:1-12. [PMID: 35369649 PMCID: PMC8959272 DOI: 10.1007/s13671-022-00353-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review This review highlights recent developments in the field of pediatric allergic contact dermatitis (ACD) and patch testing. We will review updates on the pathophysiology of contact dermatitis, discuss new contact allergens, explore the impact of dupilumab on patch testing, and provide pearls for the diagnosis and management of ACD in children. Recent Findings ACD is not a single immunologic phenomenon but rather has contributions from multiple inflammatory pathways. Emerging contact allergens include ingredients found in “slime” toys, glucose monitors and insulin pumps, and electronic equipment. Data thus far suggests that patch testing results are generally reliable in the face of concurrent dupilumab use. Summary ACD is likely underrecognized and underdiagnosed in pediatric patients, including infants and young children. Providers should keep patient-specific factors and emerging trends in mind when addressing suspected ACD, consider contact dermatitis when they encounter challenging cases of atypical, refractory, or chronic dermatitis, and feel comfortable performing patch testing in children.
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Affiliation(s)
- Elizabeth Dupuy
- Division of Pediatric Dermatology, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - Melanie Miller
- Department of Dermatology, LAC+USC Keck School of Medicine, Los Angeles, CA USA
| | - Nicole Harter
- Department of Dermatology, University of Nebraska Medical Center, Omaha, NE USA
- Division Chief, Pediatric Dermatology, Children’s Hospital & Medical Center Omaha, 8534 Cass St., Omaha, NE 68114 USA
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15
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Wee C, Tan CH, Zhao X, Yew YW, Goon A. Pattern of contact sensitisation in patients with and without atopic dermatitis in an Asian dermatology centre. Contact Dermatitis 2022; 86:398-403. [PMID: 35133669 DOI: 10.1111/cod.14068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the traditional understanding is that contact sensitisation is less frequent in atopic dermatitis (AD) patients, recent studies have shown similar or higher rates of positive patch test results in AD patients. METHODS This was a single-centre, ten-year retrospective review on contact sensitisation in patients who underwent patch testing between 2007 and 2017. The aims were to characterise the pattern of contact sensitisation and to ascertain a link between contact sensitisation and AD. RESULTS There were 4903 patients (males:females = 1:1.4; mean age 40.1 years old) included. About half (2499, 51.0%) of all patients developed at least one positive reaction. The top five frequent reactions were to nickel sulfate (45.4%), potassium dichromate (16.0%), p-phenylenediamine (13.4%), Myroxylon pereirae (11.8%) and fragrance mix I (11.2%). The overall prevalence of contact sensitisation was not significantly different between patients with or without AD. Patients with AD were less likely to develop contact allergies to budesonide and thiuram mix, and more likely to develop contact allergies to potassium dichromate. CONCLUSIONS Contact sensitisation was detected in 50% of patients patch-tested. Nickel sulfate was the most frequently sensitising allergen. The prevalence of contact allergies in atopic patients is comparable to that in non-atopic patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | | | - Yik Weng Yew
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - Anthony Goon
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
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16
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Lee EY, Wee CLP, Tan CH, Wee LWY, Lim CEE, Zhao X, Koh MJA, Yew YW, Goon ATJ. Pediatric patch testing in a multi-ethnic Asian population: A retrospective review. Pediatr Dermatol 2022; 39:69-76. [PMID: 34971009 DOI: 10.1111/pde.14904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis (ACD) is increasingly prevalent. Patch testing is the gold-standard diagnostic investigation. The aims of our study were to describe the clinical profile of pediatric patients with ACD in a multi-ethnic Asian population and identify the common contact allergens. METHODS This was a retrospective study involving children and adolescents aged 16 years or younger with clinically suspected ACD who underwent patch testing between January 2007 and March 2020 at two institutions in Singapore. Information pertaining to their demographics, atopy history, clinical presentation, and patch test results was analyzed. RESULTS A total of 252 patients were included. The mean age was 10.9 years (1.0-16.7 years). The majority were Chinese (79.8%) and girls (57.5%). Many (66.3%) had atopic dermatitis (AD), which was mild. The most common presentation was an acral eczematous rash. The sensitization rate was 50.0%. The most frequent reactions were to nickel sulfate (49.2%) and fragrance mix (19.1%). The overall rate of relevant positive patch tests was 72.5%. Patients with AD were less likely to have a reaction to fragrance mix (p = .019) and more likely to have a reaction to disperse blue (p = .041). Compared to younger children, adolescents were less likely to have a positive patch test (p = .008). Indians were also less likely to have a positive reaction (p = .004). CONCLUSION Metals and fragrances were the most common allergens causing childhood ACD in Singapore. Patients with AD were less likely to be sensitized to fragrances and more likely to be sensitized to disperse blue dye.
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Affiliation(s)
- Elis Yuexian Lee
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | | | - Chee Hian Tan
- Department of Dermatology, National Skin Centre, Singapore, Singapore
| | - Lynette Wei Yi Wee
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Charmaine En-En Lim
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Xiahong Zhao
- Research Department, National Skin Centre, Singapore, Singapore
| | - Mark Jean Aan Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yik Weng Yew
- Department of Dermatology, National Skin Centre, Singapore, Singapore.,Research Department, National Skin Centre, Singapore, Singapore
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17
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Weingarten M, Silverberg N. Follicular eczema and accentuation: A survey of published data. J Am Acad Dermatol 2021; 87:860-862. [PMID: 34808325 DOI: 10.1016/j.jaad.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/22/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Mark Weingarten
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Nanette Silverberg
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York; Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, New York.
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18
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Mitchell KN, Tay YK, Heath CR, Silverberg NB. Review article: Emerging issues in pediatric skin of color, Part 2. Pediatr Dermatol 2021; 38 Suppl 2:30-36. [PMID: 34708446 DOI: 10.1111/pde.14774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dermatology for pediatric skin of color is the application of dermatology to the genetically diverse and distinctive segment of the pediatric population that includes children of non-White racial and ethnic groups with increased pigmentation including individuals of Asian, Hispanic/LatinX, African, Native American, Pacific Island descent, indigenous people among others with overlap in particular individuals, and mixtures thereof. The discipline of pediatric skin of color can be challenging with difficulty in diagnosis of common conditions due to underlying pigmentation, variations in common hair styling practices, and differences in demographics of cutaneous disease. Whereas some conditions are more common in children of color, other conditions have nuances in clinical appearance and therapeutics with regard to skin color. This article, the second of the series, focuses on inflammatory skin disease nuances, melanocytic disorders, and hypopigmented mycosis fungoides.
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Affiliation(s)
- Krystal N Mitchell
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, NY, USA
| | - Yong Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore, Singapore
| | - Candrice R Heath
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Nanette B Silverberg
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, NY, USA
- Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, NY, USA
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19
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Kuo A, Silverberg N, Fernandez Faith E, Morgan R, Todd P. A systematic scoping review of racial, ethnic, and socioeconomic health disparities in pediatric dermatology. Pediatr Dermatol 2021; 38 Suppl 2:6-12. [PMID: 34409633 DOI: 10.1111/pde.14755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES Health disparities encompass a wide range of personal, societal, environmental, and system-based factors that contribute to inequitable health and health outcomes in vulnerable patient populations. The goal of this work was to scientifically summarize the existing published North American research on disparity as it pertains to pediatric dermatology. METHODS A systematic review was performed according to PRISMA guidelines. A medical librarian performed electronic searches from multiple electronic databases from their dates of inception to March 2021. Title and abstracts were reviewed by authors, identifying articles for full review. Data on article characteristics and identified disparities were then extracted and collected in a spreadsheet. RESULTS Fifty-one articles met final inclusion criteria, of which 25 highlighted disparities due to race/ethnicity, 13 highlighted disparities due to socioeconomic (SES), and 13 highlighted disparities due to both race/ethnicity and SES. The most frequent study designs were cross-sectional or survey, followed by retrospective cohort. Only two were prospective cohort studies. Disparities reported included reduced access to care and medications, increased school absenteeism, reduced knowledge about skin care including sun protection, increased hospitalizations and emergency department visits, and severe and persistent disease in the setting of minority race and poverty, among other indicators. CONCLUSIONS There are few, scattered research studies addressing disparity in pediatric dermatology. Greater focus will be needed in the future to improve knowledge of sources of disparity and its detrimental effects on the health of children, to rectify the notable disparity under-reporting of disparity research.
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Affiliation(s)
- Alyce Kuo
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nanette Silverberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Esteban Fernandez Faith
- Department of Pediatrics, Division of Dermatology, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Rebecca Morgan
- Kornhauser Health Science Library, University of Louisville, Louisville, Kentucky, USA
| | - Patricia Todd
- Department of Pediatrics, Division of Pediatric Dermatology, Norton Children's Medical Group and University of Louisville School of Medicine, Louisville, Kentucky, USA
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20
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Wisniewski JA, Phillipi CA, Goyal N, Smith A, Hoyt AEW, King E, West D, Golden WC, Kellams A. Variation in Newborn Skincare Policies Across United States Maternity Hospitals. Hosp Pediatr 2021; 11:1010-1019. [PMID: 34462323 DOI: 10.1542/hpeds.2021-005948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Newborn skincare influences levels of beneficial factors from vernix and vaginal secretions but also the emergence of potential skin pathogens. However, evidence-based national guidelines for newborn skincare do not exist, and actual hospital practices for newborn skincare have not been described. In this study, we test the hypothesis that US maternity hospitals follow differing policies with regard to newborn skincare. METHODS A 16-question survey querying skin care practices was distributed to nursery medical directors at the 109 US hospital members of the Better Outcomes through Research for Newborns network. Data from free text responses were coded by 2 study personnel. Survey responses were analyzed by using descriptive statistics and compared by region of the United States. RESULTS Delaying the first newborn bath by at least 6 hours is a practice followed by 87% of US hospitals surveyed. Discharging newborns without a bath was reported in 10% of hospitals and was more common for newborns born in nonacademic centers and on the West Coast. Procedures and products used for newborn skincare varied significantly. Parental education on tub immersion and soap use was also inconsistent and potentially contradictory between providers. Evidence cited by hospitals in forming their policies is scant. CONCLUSION In this study, we identify similar and strikingly different newborn skincare policies across a national network of US maternity hospitals. Research is needed to identify effects of differing skincare routines on skin integrity, infection rates, and childhood health outcomes to improve the evidence base for the care of newborn skin.
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Affiliation(s)
- Julia A Wisniewski
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Carrie A Phillipi
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon
| | - Neera Goyal
- Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anna Smith
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Alice E W Hoyt
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | | | - Dennis West
- Academic Pediatric Association, McLean, Virginia
| | | | - Ann Kellams
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
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21
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Silverberg JI, Hou A, Warshaw EM, DeKoven JG, Maibach HI, Belsito DV, Zug KA, Taylor JS, Sasseville D, Dunnick CA, Houle MC, Atwater AR, Reeder MJ, DeLeo VA, Pratt MD, Fowler JF, Zirwas MJ, Marks JG. Age-related differences in patch testing results among children: Analysis of North American Contact Dermatitis Group Data, 2001-2018. J Am Acad Dermatol 2021; 86:818-826. [PMID: 34314743 DOI: 10.1016/j.jaad.2021.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/08/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND An updated understanding of allergic contact dermatitis is needed, particularly in children. OBJECTIVES To compare positive and clinically relevant reactions in children versus adults referred for patch testing. METHODS Retrospective analysis of 1871 children and 41,699 adults from the North American Contact Dermatitis Group (NACDG) from 2001-2018. RESULTS Both final diagnosis of allergic contact dermatitis (55.2% versus 57.3%; chi square, P = .0716) and prevalence of ≥ 1 currently relevant reaction to a NACDG screening allergen (49.2% vs 52.2%; P = .1178) were similar between children and adults. Currently in children, the most common relevant allergens were nickel sulfate (17.3%), hydroperoxides of linalool (7.8%), methylisothiazolinone (7.7%), cobalt chloride (7.0%), and fragrance mix I (4.9%). Approximately a fifth of children had a positive reaction to a non-NACDG allergen. CONCLUSION Over half of children referred for patch testing were diagnosed with allergic contact dermatitis. The most common relevant allergens in children were nickel sulfate, cobalt chloride, and hydroperoxides of linalool. Twenty percent of children had at least 1 positive reaction to allergens/substances not on the NACDG screening series, underscoring the need for comprehensive testing.
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Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington, DC; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Alexander Hou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota; Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Joel G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Kathryn A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Denis Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado, Aurora, Colorado
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Quebec, Laval University, Quebec City, Quebec, Canada
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Vincent A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, California
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada
| | - Joseph F Fowler
- Division of Dermatology University of Louisville, Louisville, Kentucky
| | - Matthew J Zirwas
- Department of Dermatology, Ohio State University, Columbus, Ohio
| | - James G Marks
- Department of Dermatology, Pennsylvania State University, State College, Hershey, Pennsylvania
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22
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Burnett CL, Bergfeld WF, Belsito DV, Cohen D, Klaassen CD, Liebler DC, Marks JG, Peterson LA, Shank RC, Slaga TJ, Snyder PW, Heldreth B. Amended Safety Assessment of Methylisothiazolinone as Used in Cosmetics. Int J Toxicol 2021; 40:5S-19S. [PMID: 34259065 DOI: 10.1177/10915818211015795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Expert Panel for Cosmetic Ingredient Safety (Panel) reassessed the safety of Methylisothiazolinone, which functions as a preservative in cosmetics. The Panel reviewed relevant animal and human data provided in this safety assessment, and data from the previously published safety assessments of Methylisothiazolinone, and concluded that Methylisothiazolinone is safe for use in rinse-off cosmetic products at concentrations up to 100 ppm (ie, 0.01%) and safe in leave-on cosmetic products when they are formulated to be nonsensitizing, which may be determined based on a quantitative risk assessment or similar methodology.
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Affiliation(s)
| | | | | | - David Cohen
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - James G Marks
- Expert Panel for Cosmetic Ingredient Safety Former Member
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23
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Abstract
Allergic contact dermatitis (ACD) remains a globally prevalent disease for both children and adults. The silent ACD epidemic continues to be fueled by the introduction of novel allergens in industrial and household products and the continued presence of known allergens. In 1997, Allan Dillarstone noted a sinusoidal pattern to epidemics when allergenic preservatives were replaced by alternative chemicals within the market, which then similarly increased in allergenicity. A call for public health vigilance and prevention initiatives is needed to intervene in the ACD epidemic.
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Affiliation(s)
- Mohsen Baghchechi
- University of California, Riverside, School of Medicine, 92521 UCR Botanic Gardens Road, Riverside, CA 92507, USA
| | - Alina Goldenberg
- Dermatologist Medical Group of North County, 11943 EL Camino Real #220, San Diego, CA 92130, USA
| | - Sharon E Jacob
- University of California, Riverside, School of Medicine, 92521 UCR Botanic Gardens Road, Riverside, CA 92507, USA; Veterans Health Administration, Loma Linda, 11210 Benton Street, Loma Linda, CA 92354, USA.
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24
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Brown C, Yu J. Pediatric Allergic Contact Dermatitis. Immunol Allergy Clin North Am 2021; 41:393-408. [PMID: 34225896 DOI: 10.1016/j.iac.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Allergic contact dermatitis (ACD) affects up to 20% of adults and children, although children are infrequently patch tested. Available data suggest that children and adults, with or without atopic dermatitis, have the same prevalence of ACD. Patch testing is the gold standard for evaluation of ACD. The Pediatric Baseline Series was recently published by expert consensus for use in pediatric patch testing, with additional allergens tested as guided by history. This article examines methods of patch testing and up-to-date data on pediatric ACD. The top allergens are reviewed, and avoidance strategies are discussed.
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Affiliation(s)
- Christen Brown
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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25
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[Challenges in neonatal dermatology : An introduction]. Hautarzt 2021; 72:185-193. [PMID: 33651115 DOI: 10.1007/s00105-021-04764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
In order to support dermatologists' interest for the fascinating area of neonatal dermatology, we provide (1) an introduction to the specifics of skin barrier in premature and full-term neonates as well as their clinical implications and (2) an example of age-dependent differential diagnoses and approach to a facial vascular stain in a neonate.
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26
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Silverberg JI, Warshaw EM, Maibach HI, DeKoven JG, Taylor JS, Atwater AR, Sasseville D, Zug KA, Reeder MJ, Fowler JF, Pratt MD, Fransway AF, Zirwas MJ, Belsito DV, Marks JG, DeLeo VA. Hand eczema in children referred for patch testing: North American Contact Dermatitis Group Data, 2000-2016. Br J Dermatol 2021; 185:185-194. [PMID: 33454963 DOI: 10.1111/bjd.19818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE). OBJECTIVES To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing. METHODS A retrospective analysis (2000-2016) of North American Contact Dermatitis Group data was performed. RESULTS Of 1634 paediatric patients, 237 (14·5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49·4%), atopic dermatitis (37·1%) and irritant contact dermatitis (16·9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56·1% vs. 61·7%; χ2 -test, P = 0·11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. The allergens with the highest mean significance-prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone. CONCLUSIONS Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to the proportion found in children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.
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Affiliation(s)
- J I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Dermatology, The Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - E M Warshaw
- Department of Dermatology, Park Nicollet Health Services, Minneapolis, MN, USA.,Department of Dermatology, University of Minnesota, Minneapolis, MN, USA.,Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
| | - H I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - J G DeKoven
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
| | - J S Taylor
- Department of Dermatology, Cleveland Clinic, OH, USA
| | - A R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, NC, USA
| | - D Sasseville
- Division of Dermatology, Montreal General Hospital, McGill University, Montreal, QC, Canada
| | - K A Zug
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - M J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J F Fowler
- Division of Dermatology, University of Louisville, KY, USA
| | - M D Pratt
- Division of Dermatology, University of Ottawa, ON, Canada
| | | | - M J Zirwas
- Department of Dermatology, Ohio State University, Columbus, OH, USA
| | - D V Belsito
- Department of Dermatology, Columbia University, New York, NY, USA
| | - J G Marks
- Department of Dermatology, Pennsylvania State University, State College, PA, USA
| | - V A DeLeo
- Department of Dermatology, Keck School of Medicine, Los Angeles, CA, USA
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27
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Goossens A, Morren MA. Contact Allergy in Children. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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Neale H, Garza-Mayers AC, Tam I, Yu J. Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children. J Am Acad Dermatol 2020; 84:235-244. [PMID: 33217510 DOI: 10.1016/j.jaad.2020.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Allergic contact dermatitis (ACD), a delayed hypersensitivity skin reaction to environmental allergens, has a prevalence that is similar in children and adults. However, diagnostic testing for ACD in pediatric populations accounts for less than one tenth of all patch tests. The relative infrequency of pediatric patch testing may be attributed to the difficulty in testing in this population, which includes a smaller surface area for patch test placement and maintaining cooperation during patch testing, especially in younger children. Diagnosis can be difficult in children because the appearance of ACD can mimic other common pediatric skin conditions, particularly atopic dermatitis and irritant contact dermatitis. Comprehensive history taking, guided by patient presentation, age group, and location of dermatitis, helps build clinical suspicion. Such clinical suspicion is one of the major reasons behind patch testing, with additional indications being recalcitrant dermatitis and dermatitis with atypical distribution. US pediatric data have shown the top allergens to be metals, fragrances, topical antibiotics, preservatives, and emollients. These trends are important to recognize to guide management and accurate diagnosis, because ACD tends to persist if the allergen is not identified and can affect patients' quality of life.
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Affiliation(s)
- Holly Neale
- University of Massachusetts School of Medicine, Worcester, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Anna Cristina Garza-Mayers
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Idy Tam
- Tufts University School of Medicine, Boston, Massachusetts
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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29
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Brar KK. A review of contact dermatitis. Ann Allergy Asthma Immunol 2020; 126:32-39. [PMID: 33091591 DOI: 10.1016/j.anai.2020.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To familiarize the reader with the mechanisms and causes of contact dermatitis. DATA SOURCES Recent research articles, relevant review articles, and case series/reports in English from PubMed database, mostly from 2010 onwards. STUDY SELECTIONS Most data were in the form of retrospective studies. Efforts were made to include clinical trials; however, for newer allergens and data on biologics, case series and case reports were included. Older studies regarding the mechanism were included if they were of particular importance. RESULTS An understanding of this review should enable the reader to approach the patient with unknown dermatitis with a better understanding of the cause and management. CONCLUSION Clinical suspicion for relevant allergens combined with the interpretation of patch tests are important in the diagnosis and treatment of patients with contact dermatitis.
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Affiliation(s)
- Kanwaljit K Brar
- Allergy and Immunology, Department of Pediatrics, Hassenfeld Children's Hospital, NYU Langone Health, New York, New York.
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30
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Moustafa D, Yu J. Contact allergy to hydroperoxides of limonene and linalool in a pediatric population. J Am Acad Dermatol 2020; 83:946-947. [DOI: 10.1016/j.jaad.2020.01.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
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31
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Boonchai W, Chaiyabutr C, Charoenpipatsin N, Sukakul T. Pediatric contact allergy: A comparative study with adults. Contact Dermatitis 2020; 84:34-40. [PMID: 32696982 DOI: 10.1111/cod.13672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis is increasing. The patch test allergens included in pediatric baseline series vary globally. The worldwide prevalence of pediatric reactions to allergens needs clarification. OBJECTIVES Identify the prevalence, associated factors, and culprit allergens for contact allergy among patch-tested Thai children, and compare with those for adults. METHODS Baseline series patch test results from 2010-2019 were collected for patients younger than 18 years of age. As a control group, sex-matched adult patients were randomly selected. The results and characteristics of the two groups were compared. RESULTS The median age of 112 patch tested pediatric patients was 16 (range 2-17) years. Of the children, 35.5% had at least one positive reaction, significantly less than the 56.6% for adults. The five most common pediatric allergens were nickel sulfate (12.1%), potassium dichromate (8.0%), methylisothiazolinone (7.1%), fragrance mix II (6.0%), and carba mix (5.4%). Although similar, the 10 most common allergens of the groups differed in order. Positive reactions to cosmetic allergens were significantly less frequent among the children. Many allergens remained entirely negative. CONCLUSIONS The prevalence of positive reactions was lower in children, varying by population and region. The top-10 pediatric and adult causative allergens were almost identical. We recommend using the same baseline patch test series for children and adults in our region.
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Affiliation(s)
- Waranya Boonchai
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Norramon Charoenpipatsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanisorn Sukakul
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Abstract
PURPOSE OF REVIEW Allergic contact dermatitis (ACD) was once thought to be rare in children but recent studies have demonstrated that the prevalence of ACD is common and appears to be increasing in children. Current trends including toys, hobbies, and personal care products may play a role in potentially new allergen exposure or resurgence of certain allergens, making ACD a moving target in children. RECENT FINDINGS ACD and atopic dermatitis can coexist and certain clinical features can help differentiate ACD from endogenous atopic dermatitis in children. It is important to consider ACD in children with recalcitrant atopic dermatitis or dermatitis with atypical distribution. Patch testing has become a more common practice in children. In 2018, the first expert consensus-derived pediatric baseline series consisting of 38 allergens was proposed to aid in the diagnosis of ACD in children. Comparing recent patch testing data in the pediatric population, the top allergens ubiquitously identified were nickel, cobalt, neomycin, Myroxylon pereirae (balsam of Peru), fragrance mix I, fragrance mix II, methylisothiazolinone, methylchloroisothiazolinone/ methylisothiazolinone, formaldehyde, and lanolin. SUMMARY ACD is a common problem in children. Detection through patch testing, avoidance of offending allergens, and prevention of common allergens are the main focus of management of ACD in children.
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33
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Sindle A, Jacob SE, Martin K. Common Allergens and Considerations When Performing Pediatric Patch Testing. Dermatol Clin 2020; 38:321-327. [DOI: 10.1016/j.det.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW Allergic contact dermatitis (ACD) affects 20% of children. However, diagnosis of ACD may be underreported in children due to lack of recognition. Patch testing is the gold standard for evaluation of ACD in children but poses unique challenges in this population. RECENT FINDINGS Recent studies highlight the significance of ACD and the utility of patch testing in children. Evaluation of ACD in children is difficult and requires knowledge of a child's exposure history, careful selection of allergens, and knowledge of specialized patch testing considerations to minimize irritation and maximize cooperation. Until recently, there were no agreed upon patch test series for children. In 2018, a comprehensive pediatric baseline series was published enabling thorough evaluation of ACD in children (Yu J, Atwater AR, Brod B, Chen JK, Chisolm SS, Cohen DE, et al. Dermatitis. 2018;29(4):206-12). This review provides an overview of the current literature, an update on pediatric ACD, and patch testing methods in children to effectively evaluate and manage ACD.
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Affiliation(s)
- Idy Tam
- Tufts University School of Medicine, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, Suite 200, Boston, MA, 02114, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, Suite 200, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
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35
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A Hands-on Approach to Contact Dermatitis and Patch Testing. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:1883-1893. [DOI: 10.1016/j.jaip.2020.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 12/16/2022]
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36
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Hong CH, Joseph M, Kim VHD, Lansang P, Lara-Corrales I. Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section II: Comorbid Disease in Pediatric Atopic Dermatitis. J Cutan Med Surg 2019; 23:12S-18S. [DOI: 10.1177/1203475419882655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pediatric atopic dermatitis (AD) is one of the most common skin conditions encountered by health-care providers caring for infants, children, and adolescents. Pediatric patients with AD may present with other allergic and nonallergic comorbidities that require appropriate treatment and referral. They may also experience a trajectory of allergic diseases known as the atopic march, which depends on a complex interaction between genetic and environmental factors and likely involves early epidermal barrier dysfunction. Here we provide a review and clinical recommendations on the assessment and referral of comorbidities in pediatric AD.
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Affiliation(s)
- Chih-ho Hong
- Dr. Chih-ho Hong Medical Inc., Surrey, BC, Canada
- Probity Medical Research, Waterloo, ON, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Marissa Joseph
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| | - Vy HD Kim
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Immunology & Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Perla Lansang
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Irene Lara-Corrales
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
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37
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Romita P, Foti C, Stingeni L, Hansel K, Magrone T, Belsito DV, Bonamonte D. Contact Allergy in Children with Atopic Dermatitis: A Retrospective Study. Endocr Metab Immune Disord Drug Targets 2019; 19:1083-1087. [DOI: 10.2174/1871530319666190211123342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/22/2022]
Abstract
Background:
The relationship between atopic dermatitis and allergic contact dermatitis is
frequently debated, particularly in children. The impaired skin barrier of atopic subjects can facilitate
the penetration of exogenous agents and its mutations in the filaggrin gene might be implicated in an
increased risk to develop contact dermatitis. Moreover, atopic children are protractedly exposed to
chemical substances contained in skin care products from an early age.
Patients And Methods:
The aim of this retrospective study is to determine if atopic children are more
prone to allergic contact dermatitis and which substances are more frequently related to this disease.
From 2014 to 2016, a total of 268 children under 14 years with a history of eczematous dermatitis, of
whom 141 (52.6%) were affected, and 127 (47.4%) were not affected by AD, underwent patch testing
with the baseline S.I.D.A.P.A standard series.
Results:
Based on the results of our study, the prevalence of contact allergy in atopic children is comparable
to that noted in non-atopic children. The most frequent causes of contact allergy in children are
fragrances, and their prevalence is significantly higher in atopic children (19.9%) than in non-atopic
ones, (11.8%; p < .05).
Conclusion:
Our study highlights the importance of patch testing in atopic children for continuously
monitoring the trends and changes of contact allergies that are a common disease and is even significantly
increasing for some allergens, as fragrances. We may speculate that the protracted use of skincare
products, associated with the impaired skin barrier of atopic children, enhances the risk of sensitization
to the ingredients of these products.
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Affiliation(s)
- Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
| | - Luca Stingeni
- Clinical, Allergological and Venereological Dermatology Section, Department of Medicine, University of Perugia, IT-06129 Perugia, Italy
| | - Katharina Hansel
- Clinical, Allergological and Venereological Dermatology Section, Department of Medicine, University of Perugia, IT-06129 Perugia, Italy
| | - Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, School of Medicine, Bari, Italy
| | - Donald V. Belsito
- Department of Dermatology, Columbia University Medical Center, New York, NY, United States
| | - Domenico Bonamonte
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, IT-70124 Bari, Italy
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38
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Novosel T, Rundle CW, Yu JD, Jacob SE. Art of prevention: The importance of bath time and avoiding extended exposure to irritating and allergenic chemicals. Int J Womens Dermatol 2019; 5:152-154. [PMID: 31360747 PMCID: PMC6637102 DOI: 10.1016/j.ijwd.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Tracy Novosel
- Department of Dermatology, Atlantic Dermatology Associates, Virginia Beach, Virginia
| | | | - Jiade D. Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sharon E. Jacob
- Department of Dermatology, Loma Linda University, Loma Linda, California
- Corresponding Author.
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39
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Holmes GA, Vassantachart JM, Sung CT, Goldenberg A, Jacob SE. Contact dermatitis and atopic dermatitis: two tales, an interwoven story. GIORN ITAL DERMAT V 2019; 154:425-434. [DOI: 10.23736/s0392-0488.18.06236-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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40
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Abstract
Dermatitis is one of the most common illnesses encountered by healthcare providers and the causes are numerous. Contact dermatitis is the form of dermatitis resulting from contact with the environment, and it may be either irritant or allergic in nature. Patch testing has been the gold standard for diagnosis of allergic contact dermatitis since its formal description over 100 years ago by Jadassohn. While this diagnostic tool may seem simple to us today, there are numerous potential points for error that the practitioner must keep in mind. Patient selection, technique of patch test placement, allergen selection, patch test reading and interpretation, and patient management all must be considered. To simply apply a given set of test allergens indiscriminately and not be prepared to interpret the results accurately with patient education and management in mind would be a great failure. Conversely, with experience and the proper knowledge base some of the most complex dermatitis questions can be answered.
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Affiliation(s)
- Betty A Uyesugi
- Dermatology Physicians, Inc., 360 Plaza Drive Suite C, Columbus, IN, 47201, USA.,Indianapolis College of Osteopathic Medicine, Marian University, Indianapolis, USA
| | - Michael P Sheehan
- Dermatology Physicians, Inc., 360 Plaza Drive Suite C, Columbus, IN, 47201, USA. .,Indianapolis College of Osteopathic Medicine, Marian University, Indianapolis, USA. .,School of Medicine Department of Dermatology, Indiana University, Bloomington, USA.
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41
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Anderson LE, Treat JR, Brod BA, Yu J. "Slime" contact dermatitis: Case report and review of relevant allergens. Pediatr Dermatol 2019; 36:335-337. [PMID: 30865309 DOI: 10.1111/pde.13792] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Homemade "slime" is currently a popular childhood hobby that can cause allergic and irritant contact dermatitis. We describe a case of hand dermatitis due to homemade "slime" with a positive patch test to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI. The most common potential allergens in "slime" collected from a review of "slime" recipes found on the Internet are reviewed.
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Affiliation(s)
- L Elizabeth Anderson
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - James R Treat
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bruce A Brod
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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42
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Goldenberg A, Jacob S. The atopic paradox. Br J Dermatol 2019; 180:704-705. [DOI: 10.1111/bjd.17620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Goldenberg
- Department of Dermatology University of California San Diego San Diego CA U.S.A
| | - S.E. Jacob
- Department of Dermatology Loma Linda University Loma Linda CA U.S.A
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43
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Lio PA. The many faces of eczema and its treatments. Ann Allergy Asthma Immunol 2019; 120:553-554. [PMID: 29891117 DOI: 10.1016/j.anai.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Peter A Lio
- Medical Dermatology Associates of Chicago, Chicago, Illinois.
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44
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Lagrelius M, Wahlgren C, Matura M, Bergström A, Kull I, Lidén C. Atopic dermatitis at preschool age and contact allergy in adolescence: a population‐based cohort study. Br J Dermatol 2019; 180:782-789. [DOI: 10.1111/bjd.17449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- M. Lagrelius
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - C.‐F. Wahlgren
- Dermatology Unit Department of Medicine Solna Karolinska Institutet, and Karolinska University Hospital SE‐171 76 Stockholm Sweden
| | - M. Matura
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - A. Bergström
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council SE‐113 65 Stockholm Sweden
| | - I. Kull
- Department of Clinical Science and Education Stockholm South General Hospital Karolinska Institutet, and Sachs’ Children's Hospital SE‐118 83 Stockholm Sweden
| | - C. Lidén
- Institute of Environmental Medicine Karolinska Institutet SE‐171 77 Stockholm Sweden
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45
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Milam EC, Jacob SE, Cohen DE. Contact Dermatitis in the Patient with Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:18-26. [DOI: 10.1016/j.jaip.2018.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/20/2022]
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46
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47
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Rastogi S, Patel KR, Singam V, Silverberg JI. Allergic contact dermatitis to personal care products and topical medications in adults with atopic dermatitis. J Am Acad Dermatol 2018; 79:1028-1033.e6. [DOI: 10.1016/j.jaad.2018.07.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/10/2018] [Accepted: 07/14/2018] [Indexed: 11/26/2022]
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Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future. Clin Rev Allergy Immunol 2018; 56:86-98. [DOI: 10.1007/s12016-018-8711-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Boonstra M, Rustemeyer T, Middelkamp‐Hup M. Both children and adult patients with difficult-to-treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized. J Eur Acad Dermatol Venereol 2018; 32:1554-1561. [PMID: 29578626 PMCID: PMC6175158 DOI: 10.1111/jdv.14973] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/08/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Concomitant allergic contact dermatitis (ACD) has been described as a possible cause of atopic dermatitis (AD) becoming difficult-to-treat. However, contact sensitization in this patient group has barely been studied. OBJECTIVE To study the occurrence of ACD in a population of difficult-to-treat AD children and adults. METHODS Clinical and patch test information of 48 patients with difficult-to-treat AD unresponsive to conventional outpatient treatments was gathered retrospectively. We studied prevalence and relevance of common allergens, performed dynamic patch test analysis and assessed occurrence of polysensitization. RESULTS In 48 patients with difficult-to-treat AD, 75% (n = 36/48) had a concomitant contact allergy, and 39% (n = 14/36) of these patients were polysensitized. ACD and polysensitization prevalences were equal amongst children and adults. The most frequent and relevant reactions were seen against wool alcohols, surfactants cocamidopropyl betaine and dimethylaminopropylamine, bichromate and fragrance mix I. Dynamic pattern analysis showed these reactions to be mostly allergic and not irritative of nature. CONCLUSION Difficult-to-treat AD patients frequently suffer from concomitant (multiple) contact allergies, and this may be a reason why the AD turns into a difficult-to-treat disease. Awareness of this phenomenon is necessary, as pragmatic implementation of allergen avoidance strategies may be helpful in getting disease control in this population.
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Affiliation(s)
- M. Boonstra
- Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
- Department of DermatologyAcademic Medical CenterAmsterdamThe Netherlands
| | - T. Rustemeyer
- Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
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Hamann D, Ridpath A, Fernandez Faith E. Pediatric "pet consort dermatitis"-Allergic contact dermatitis from transfer of bronopol from a pet cat. Pediatr Dermatol 2018; 35:e332-e333. [PMID: 29943851 DOI: 10.1111/pde.13572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Consort dermatitis refers to an allergic contact dermatitis caused by transfer from an intimate contact to a sensitized patient. Although close contact with other humans most commonly provokes consort dermatitis, pets have been the source in a minority of cases. We present a unique case of transfer dermatitis from a patient's cat litter to her forearms. Pediatric dermatologists should be aware of the possibility of consort or "transfer" allergic contact dermatitis from pets.
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Affiliation(s)
- Dathan Hamann
- Division of Dermatology, Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Alyson Ridpath
- Division of Dermatology, Ohio Health Riverside Hospital, Columbus, Ohio, USA
| | - Esteban Fernandez Faith
- Division of Dermatology, Department of Medicine, The Ohio State University, Columbus, Ohio, USA.,Division of Pediatric Dermatology, Nationwide Children's Hospital, Columbus, Ohio, USA
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