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Kalay Yildizhan I, Boyvat A. The Contact Sensitivity of Turkish Children and Adolescents to European Baseline Series Allergens between 2013 and 2023. Dermatol Pract Concept 2024; 14:dpc.1402a151. [PMID: 38810081 PMCID: PMC11135937 DOI: 10.5826/dpc.1402a151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Increasing the numbers of patch testing in suspected children increases the rate of diagnosis of allergic contact dermatitis and the identification of clinically relevant allergens. OBJECTIVE The aim of this study was to identify the most frequently observed allergens among Turkish children and adolescents patch-tested in 2013-2023. METHODS The patch test results of 160 patients (age ≤18) were analyzed retrospectively. The frequency of contact allergens and distribution of positive results in terms of sex, age group (children and adolescents), and the presence of atopic dermatitis (AD) were identified. RESULTS Forty-nine patients (30.6%) (34 girls and 15 boys) exhibited positive patch test reactions to a minimum of one allergen, and contact sensitivity was statistically significantly higher in girls (P=0.034). The five most frequent allergens were nickel sulfate (10.6%), MCI/MI (8.1%), cobalt chloride (5.6%), p-phenylenediamine (PPD) (5%), and MI (3.5%). No significant association was observed between patch test positivity and age groups (P>.05). Nickel sulfate sensitivity was significantly higher in girls than in boys (P=.043). A positive reaction was detected in 31.3% of patients with AD and in 33.7% of those without (P>.05), and a statistically significant relationship was observed between contact sensitivity to fragrance allergens and AD (P=.046). CONCLUSION Metals and preservatives represent the most frequent allergens in Turkish children and adolescents. Metal sensitivity is expected to decrease as legislation is enforced. Regulatory measures are now required to reduce MI and MCI/MI contact allergy in Turkey.
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Affiliation(s)
| | - Ayse Boyvat
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
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Kakşi SA, Kahraman FC, Akdeniz N, Özen T. Results of the patch tests with European baseline series in children: Five years of experience from a single center in Turkey and a review of the literature. J Cosmet Dermatol 2023; 22:1071-1076. [PMID: 36437575 DOI: 10.1111/jocd.15531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis (ACD) is increasingly prevalent. Patch testing is the gold-standard diagnostic method. AIMS Our study aimed to identify common contact-sensitizing allergens in Turkish children. PATIENTS/METHODS We retrospectively analyzed the patch test results and characteristics of 191 pediatric patients [114 (59.7%) females, 77 (40.3%) males], who received the diagnosis of allergic contact dermatitis between 2015 and 2019. RESULTS The mean age of the patients was 12.2 years (range 4-18 years). Thirty-six (18.8%) of the patients in the study group had positive patch test outcomes with 56 positive allergens. Girls had a significantly higher rate of total positive patch test results than boys (75%/25%; p = 0.003, p < 0.05). The most frequent four allergens were nickel sulfate (n = 20, 10.4%), cobalt chloride (n = 6, 3.14%), p-phenylenediamine (n = 5, 2.61%), Methylchloroisothiazolinone/methylisothiazolinone (n = 5, 2.61%), respectively. CONCLUSIONS In our study, we discovered that in addition to the frequently encountered metal allergens such as nickel and cobalt, p-phenylenediamine and Methylchloroisothiazolinone/methylisothiazolinone sensitivities were frequent in the Turkish population. p-phenylenediamine sensitization can cause serious systemic dermatitis during the lifetime of children. We suggest that in Turkey personal care and hygiene products containing Methylchloroisothiazolinone/methylisothiazolinone should be legally regulated. Since childhood contact dermatitis may have an impact on the quality of life by influencing family and social life, suspected allergens should be detected as early as possible.
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Affiliation(s)
- Sümeyye Altıntaş Kakşi
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Filiz Cebeci Kahraman
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Necmettin Akdeniz
- Department of Dermatology, İstanbul Şişli Memorial Hospital, İstanbul, Turkey
| | - Tunç Özen
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
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Yılmaz Z, Özkaya E. Patch-test results in terms of the recently recommended allergens in children and adolescents: A retrospective cohort study over 22 years from Turkey. Contact Dermatitis 2021; 85:198-210. [PMID: 33759232 DOI: 10.1111/cod.13842] [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] [Received: 11/19/2020] [Revised: 03/06/2021] [Accepted: 03/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A European pediatric patch-test series was suggested recently. OBJECTIVES To evaluate the patch-test results in children (<10-years-old) and adolescents (10- to 18-years-old) in Turkey, focusing on the clinical/occupational relevance and the diagnostic value of the recently suggested series. PATIENTS AND METHODS A retrospective cohort study on 317 consecutively patch-tested patients ≤18 years of age, between 1996 and 2017. RESULTS The contact sensitization rate was 46.1%. Allergic contact dermatitis (ACD) was diagnosed in 30.9%, comprising non-occupational (84.7%) and occupational (15.3%) ACD. Nickel was the leading allergen in almost every age group. Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was the clinically most relevant allergen, followed by p-phenylenediamine (PPD), ammonium persulfate, fragrance mix I, nickel sulfate, and mercury/mercury(II)amidochloride. Occupational ACD was most frequently seen in hairdresser apprentices (adolescents only) who were sensitized with PPD ± ammonium persulfate. ACD from MCI/MI increased to 5-fold, ammonium persulfate and mercurial compounds to 2-fold, and PPD to 1.7-fold after 2007. Almost one third of patients would be missed by testing only with the recommended allergens. CONCLUSIONS For patch testing in Turkish children and adolescents, we suggest additionally testing with ammonium persulfate, mercury/mercury(II)amidochloride, toluenesulfonamide formaldehyde resin, and polyethylene glycol, the latter as a marker for nitrofurazone allergy, in appropriate patients.
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Affiliation(s)
- Zeynep Yılmaz
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Clinic for Dermatology and Venereology, Boyabat 75th Year State Hospital, Sinop, Turkey
| | - Esen Özkaya
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Contact allergen sensitivity in children with contact dermatitis. Turk Arch Pediatr 2021; 56:51-56. [PMID: 34013230 DOI: 10.14744/turkpediatriars.2020.79577] [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: 12/16/2019] [Accepted: 07/02/2020] [Indexed: 11/20/2022]
Abstract
Objective Irritant contact dermatitis and Allergic contact dermatitis are two distinct forms of contact dermatitis. Allergic contact dermatitis is a Type 4 (delayed-type) hypersensitivity reaction that occurs during subsequent contact with an allergen to a previously sensitized person. The number of allergens that cause allergic contact dermatitis is increasing day by day. Although it is not the gold standard for the detection of these allergens, skin patch testing is a very helpful method. This study aimed to determine the most common contact allergens in the pediatric age group. Material and Methods All patients with the diagnosis of contact dermatitis who underwent a skin patch test (TRUE TEST) in the department of Pediatric Allergy and Immunology between March 2017-February 2018 were enrolled in this study. The patch test was evaluated 72 hours later by the same physician and interpreted as recommended by the American Academy of Dermatology. In addition to the patient files, demographic and clinical characteristics, localization of lesions, and itch score according to visual analog scale were recorded. Results A total of 80 children enrolled in the study; 45 (56.3%) were girls and 35 (43.7%) were boys. The mean age of the children was 7.37±3.84 years and 57.5% of the patients who underwent skin patch testing had a positive response to at least one or more allergens. The most common allergens were Nickel sulfate, CI + Me-Isothiazolinone, Thiuram Mix, Formaldehyde, and P-tert-butylphenol formaldehyde resin (14.8%, 10%, 6.3%). There was no difference in terms of age, sex, duration of complaints, and pruritus score according to nickel sensitization. Conclusion In the presence of chronic dermatitis in children, allergic contact dermatitis should be considered in the differential diagnosis. The culprit allergen should be determined. Also, the most common contact allergen is Nickel Sulphate in the world and the increased sensitization to other allergens is due to the increased contact of children with cosmetics and different contact allergens.
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Ozceker D, Haslak F, Dilek F, Sipahi S, Yucel E, Guler N, Tamay Z. Contact sensitization in children with atopic dermatitis. Allergol Immunopathol (Madr) 2019; 47:47-51. [PMID: 30193890 DOI: 10.1016/j.aller.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/13/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Atopic dermatitis is a common illness in childhood. Children with atopic dermatitis are prone to develop cutaneous sensitization due to skin barrier dysfunction. AIM The aim of this study was to evaluate the frequency of cutaneous sensitizations in patients with atopic dermatitis and to identify the most frequent causative allergens. STUDY DESIGN The study group consisted of 112 children with atopic dermatitis, aged 1-18 years (median 88.5 months) and 39 healthy controls, aged 1-8 years (median 88.48 months). METHODS The diagnosis of atopic dermatitis was established by modified Hanifin and Rajka criteria; severity of the disease was assessed by scoring of atopic dermatitis. Serum blood eosinophil count, total IgE and skin prick tests for common aeroallergens and food allergens were performed. Patch tests with cosmetic series and European standard patch test series (Stallegenes© Ltd, Paris, France) were applied. RESULTS Of the children with atopic dermatitis, 17% (n=19) were sensitized to either cosmetic or standard series or both of them; no children in the control group had a positive patch test (p=0.001). Atopy and severity of atopic dermatitis was not a significant risk factor for cutaneous sensitization. The most common allergens were Nickel sulphate and Methychloroisothiazinolone (4.5% and 4.5%) in the European standard patch test and cocamidoproplybetaine (12.5%) in the cosmetic series patch test. CONCLUSION Cutaneous sensitization can develop in children with atopic dermatitis, therefore allergic contact dermatitis should be kept in mind.
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Zafrir Y, Trattner A, Hodak E, Eldar O, Lapidoth M, Ben Amitai D. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. Pediatr Dermatol 2018; 35:76-86. [PMID: 29143366 DOI: 10.1111/pde.13333] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. METHODS The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. RESULTS Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). CONCLUSION Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.
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Affiliation(s)
- Yaron Zafrir
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Akiva Trattner
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmillia Hodak
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oren Eldar
- Department of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Moshe Lapidoth
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Laser Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Dan Ben Amitai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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Para-phenylenediamine allergic contact dermatitis due to henna tattoos in a child and adolescent population. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.anpede.2016.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rodrigues DF, Goulart EMA. Patch-test results in children and adolescents: systematic review of a 15-year period. An Bras Dermatol 2016; 91:64-72. [PMID: 26982781 PMCID: PMC4782649 DOI: 10.1590/abd1806-4841.20163927] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022] Open
Abstract
The number of studies on patch-test results in children and adolescents has
gradually increased in recent years, thus stimulating reviews. This paper is a
systematic review of a 15-year period devoted to studying the issue. Variations
pertaining to the number and age groups of tested children and/or adolescents,
the number of subjects with atopy/atopic dermatitis history, the quantity, type
and concentrations of the tested substances, the test technique and type of data
regarding clinical relevance, must all be considered in evaluating these
studies, as they make it harder to formulate conclusions. The most common
allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and
neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance,
potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids
health professionals in planning preventive programs aimed at improving
children's quality of life and ensuring that their future prospects are not
undermined.
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Mortazavi H, Ehsani A, Sajjadi SS, Aghazadeh N, Arian E. Patch testing in Iranian children with allergic contact dermatitis. BMC DERMATOLOGY 2016; 16:10. [PMID: 27405224 PMCID: PMC4943022 DOI: 10.1186/s12895-016-0047-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/30/2016] [Indexed: 12/23/2022]
Abstract
Background Allergic contact dermatitis is a common disorder in adults and children alike and appears to be on the increase. The purpose of this study was to determine the sensitization trends in Iranian children with contact dermatitis. Methods The result of 109 patch tests performed using the 24 allergens of the European Standard Series in patients below 18 years old from September 2007 to March 2009 were recorded and analyzed. The tests were evaluated at 48 and 72 h after performing. Results The study population consisted of 72 (66.1 %) females and 37 (33.9 %) males. Hands were the most commonly affected anatomic site. In the final evaluation of the tests on day three, 51 (46.8 %) individuals showed a positive reaction to at least one allergen. Females were significantly more likely to show a positive response to at least one allergen (p-value = 0.031, odds ratio: 2.46). The most common allergens were nickel sulfate, cobalt, methylisothiazolinone, and colophony with 21 (19.3 %), 11 (10.1 %), 7 (6.4 %), and 6 (5.5 %) positive reactions, respectively. Contact allergy to nickel sulfate was more common in females than males (23.6 % vs. 10.8 %). There was no statistically significant relationship between personal or family history of atopy and a positive reaction to patch testing. The clinical and practical relevance were assessed for nickel and cobalt with a clinical current relevance in 11 (52.3 %) and 4 (36.4 %), respectively. Conclusions Nickel sulfate, cobalt, methylisothiazolinone, and colophony are the most common allergens responsible for induction of allergic contact dermatitis in Iranian children and adolescents. Females tended to show more positive reactions to allergens. Electronic supplementary material The online version of this article (doi:10.1186/s12895-016-0047-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hossein Mortazavi
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhooshang Ehsani
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajed Sajjadi
- Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nessa Aghazadeh
- Autoimmune Bullous Diseases Research Center, Razi Dermatology Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Razi Dermtology Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,Children's Medical Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Ortiz Salvador JM, Esteve Martínez A, Subiabre Ferrer D, Victoria Martínez AM, de la Cuadra Oyanguren J, Zaragoza Ninet V. [Para-phenylenediamine allergic contact dermatitis due to henna tattoos in a child and adolescent population]. An Pediatr (Barc) 2016; 86:122-126. [PMID: 27174179 DOI: 10.1016/j.anpedi.2016.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/18/2016] [Accepted: 02/20/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Henna tattoos are a very common practice in the adolescent population. Henna is very often admixed with para-phenylenediamine (PPDA) to improve the appearance of the tattoo. PPDA is a potent allergen, and is a frequent cause of allergic contact dermatitis (ACD). MATERIAL AND METHOD A study was conducted on the results of 726 consecutive children who had been patch tested in the University General Hospital Consortium of Valencia between 1980 and 2015. RESULTS Almost half (49.7%; (361 cases) of the children had one or more positive patch test findings, with 4.7% (34) being allergic to PPDA. Mean age of patients allergic to PPDA was 12.4 years, and 44.2% were male. There were 2 cases (5.9%) of atopic dermatitis. Of the positive reactions, 73.5% were considered to be current clinically relevant. The sensitisation origin was a Henna tattoo in 50% of cases. CONCLUSION PPDA sensitisation is relatively common in the child and adolescent population. The most frequent origin is the performing of Henna tattoos adulterated with PPDA. Adolescents are at the higher risk of developing ACD due to Henna tattoos. Henna tattooing should be strongly discouraged in children.
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Affiliation(s)
| | - Altea Esteve Martínez
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
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Rodrigues DF, Goulart EMA. Patch test results in children and adolescents. Study from the Santa Casa de Belo Horizonte Dermatology Clinic, Brazil, from 2003 to 2010. An Bras Dermatol 2016; 90:671-83. [PMID: 26560213 PMCID: PMC4631233 DOI: 10.1590/abd1806-4841.20153902] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/12/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patch testing is an efficient method to identify the allergen responsible for
allergic contact dermatitis. OBJECTIVE To evaluate the results of patch tests in children and adolescents comparing these
two age groups' results. METHODS Cross-sectional study to assess patch test results of 125 children and adolescents
aged 1-19 years, with suspected allergic contact dermatitis, in a dermatology
clinic in Brazil. Two Brazilian standardized series were used. RESULTS Seventy four (59.2%) patients had "at least one positive reaction" to the patch
test. Among these positive tests, 77.0% were deemed relevant. The most frequent
allergens were nickel (36.8%), thimerosal (18.4%), tosylamide formaldehyde resin
(6.8%), neomycin (6.4%), cobalt (4.0%) and fragrance mix I (4.0%). The most
frequent positive tests came from adolescents (p=0.0014) and females (p=0.0002).
There was no relevant statistical difference concerning contact sensitizations
among patients with or without atopic history. However, there were significant
differences regarding sensitization to nickel (p=0.029) and thimerosal (p=0.042)
between the two age groups under study, while adolescents were the most
affected. CONCLUSION Nickel and fragrances were the only positive (and relevant) allergens in children.
Nickel and tosylamide formaldehyde resin were the most frequent and relevant
allergens among adolescents.
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Aquino M, Fonacier L. The Role of Contact Dermatitis in Patients with Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:382-7. [DOI: 10.1016/j.jaip.2014.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 12/25/2022]
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Abstract
Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. During the last decade, there has been a heightened awareness of this disease in the pediatric population. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred children with suspected ACD ranges from 27 to 95.6 %. The most common allergens in children in North America are nickel, neomycin, cobalt, fragrance, Myroxylon pereirae, gold, formaldehyde, lanolin/wool alcohols, thimerosal, and potassium dichromate. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.
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Güner E, Kalkan G, Meral E, Baykır M. The triggering role of allergic contact dermatitis in discoid lupus erythematosus. Cutan Ocul Toxicol 2013; 32:194-9. [DOI: 10.3109/15569527.2012.751390] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Brandão MHT, Gontijo B. Contact sensitivity to metals (chromium, cobalt and nickel) in childhood. An Bras Dermatol 2012; 87:269-76. [DOI: 10.1590/s0365-05962012000200012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 03/20/2011] [Indexed: 11/22/2022] Open
Abstract
Metals, especially nickel, are the most common contact allergens in children. Recent data has shown increased incidence of allergy in industrialized countries. Sensitization can occur at any age, even in neonates. Costume jewelry, particularly earrings, is linked to increased sensitization to nickel. Sensitization to cobalt often occurs by the use of costume jewelry. The most common source of sensitization to chromium is leather. Due to the absence of a specific therapy, the main treatment is to identify and avoid the responsible allergens. This article presents an updated view on the epidemiological and clinical aspects of contact allergy to metals, focusing on prevention strategies and risk factors, and warns about possible and new sources of contact.
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Simonsen AB, Deleuran M, Johansen JD, Sommerlund M. Contact allergy and allergic contact dermatitis in children - a review of current data. Contact Dermatitis 2011; 65:254-65. [DOI: 10.1111/j.1600-0536.2011.01963.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Spornraft-Ragaller P, Kämmerer E, Gillitzer C, Schmitt J. Severe allergic reactions to para-phenylenediamine in children and adolescents: should the patch test concentration of PPD be changed? J Dtsch Dermatol Ges 2011; 10:258-64. [PMID: 21812929 DOI: 10.1111/j.1610-0387.2011.07756.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Semipermanent henna tattoos containing para-phenylenediamine (PPD) are a well-known cause of severe contact dermatitis, mainly in children. Another relevant exposure source to PPD are hair dyes, which are increasingly used by children and have also been reported to cause intense facial and scalp dermatitis. German patch test guidelines for children recommend that PPD should only be tested in patients who have had a henna tattoo, and then at a reduced concentration of PPD 0.5 % for 24 hours. PATIENTS AND METHODS We report on patch test results in four patients, three children and one adolescent, with a history of contact dermatitis to henna tattoos or hair dye. We used the recommended or even lower patch test concentrations of PPD with 24-hours exposure in all patients. RESULTS AND CONCLUSION All patients showed very strong patch test reactions to PPD and cross-reactions to related compounds even after dilution of PPD to as low as 0.05 %. Therefore, we suggest that in children with a history of allergic reactions to this compound, a titration test should be performed beginning at a concentration of maximal 0.05 %. This procedure has also been proposed previously based on a larger cases series in adults.
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Affiliation(s)
- Petra Spornraft-Ragaller
- Clinic and Polyclinic for Dermatology, Carl Gustav Carus University Hospital, Technical University Dresden, Fetscherstrasse 74, Dresden, Germany.
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Belloni Fortina A, Romano I, Peserico A, Eichenfield LF. Contact sensitization in very young children. J Am Acad Dermatol 2011; 65:772-779. [PMID: 21616561 DOI: 10.1016/j.jaad.2010.07.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 06/29/2010] [Accepted: 07/14/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Allergic contact dermatitis is an increasingly recognized clinical problem in children. OBJECTIVE The aim of our study was to evaluate contact sensitization in patients younger than 3 years of age with suspected contact dermatitis. METHODS During a 6-year period (2002-2008), 321 children underwent routine patch testing with a screening pediatric standard series of 30 allergens. RESULTS Two hundred children (62.3%; 102 girls and 98 boys aged 3-36 months [mean age 27 + 5.6 months]) developed at least one positive reaction. The most frequent reactions were to nickel sulfate (26.8%), followed by potassium dichromate (9%), cocamidopropylbetaine (7.2%), cobalt chloride (6.2%), neomycin sulfate (5%), and methylchloroisothiazolinone/methylisothiazolinone (4.4%). The prevalence of contact sensitization was similar in children with (61.3%) and without (63%) atopic dermatitis. LIMITATIONS The prevalence of contact sensitization in children younger than 3 years of age was not compared with the prevalence in older children. CONCLUSION A high prevalence of contact sensitization was found in preschool children, even younger than 3 years of age. Patch testing should be considered in this age group when persistent dermatitis does not respond to conventional treatment.
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Affiliation(s)
| | - Ilaria Romano
- Dermatology Unit, Department of Pediatrics, University of Padova, Padua, Italy
| | | | - Lawrence F Eichenfield
- Pediatric and Adolescent Dermatology, Rady Children's Hospital, University of California, San Diego, California
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Spornraft-Ragaller P, Schnuch A, Uter W. Extreme patch test reactivity to p-phenylenediamine but not to other allergens in children. Contact Dermatitis 2011; 65:220-6. [DOI: 10.1111/j.1600-0536.2011.01930.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bonitsis NG, Tatsioni A, Bassioukas K, Ioannidis JPA. Allergens responsible for allergic contact dermatitis among children: a systematic review and meta-analysis. Contact Dermatitis 2011; 64:245-57. [DOI: 10.1111/j.1600-0536.2010.01860.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Milingou M, Tagka A, Armenaka M, Kimpouri K, Kouimintzis D, Katsarou A. Patch tests in children: a review of 13 years of experience in comparison with previous data. Pediatr Dermatol 2010; 27:255-9. [PMID: 20609142 DOI: 10.1111/j.1525-1470.2010.01128.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The true prevalence of allergic contact dermatitis (ACD) in children remains unknown. Our aim was to compare the results of patch tests in children with suspected ACD between two different periods of time and identify possible changes in emerging allergens. We compared contact allergens, gender, age distribution, and personal history of atopic dermatitis (AD), in correlation with the positivity of patch tests, between two equal periods of time (232 children tested during 1980-1993, period A, and 255 children during 1994-2007, period B) in the same region and in the same institution. Patch test positivity was 47.8% in period A, and 60% in period B (p = 0.083). The most common allergens in period A were: nickel sulfate (16.3%), cobalt chloride (8.6%), fragrance mix (7.3%), potassium dichromate (4.3%), and thimerosal only (1.7%). In period B, the allergen distribution was as follows: nickel sulfate (21.56%), thimerosal (18.03%), cobalt chloride (12.9%), potassium dichromate (9.4%), and fragrance mix (4.7%). Girls were more likely to have a positive patch test compared with boys, with reactions in 53% of girls and 39% of boys in period A (p = 0.003), and 61% of girls and 58% of boys in period B (p = 0.691). Twenty-nine per cent of patients with positive results had a personal history of AD in period A and 44% in period B (p = 0.015). Differences in the positivity of allergens between different time periods reflect changes in habits, of allergens exposure or preventive measures.
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Affiliation(s)
- Maria Milingou
- Department of Dermatology, University of Athens, A. Sygros Hospital, Athens, Greece
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Adişen E, Onder M, Terzioglu Y. A retrospective study of patients with facial allergic contact dermatitis patch tested with the European standard series in Turkey. J Eur Acad Dermatol Venereol 2009; 23:704-5. [PMID: 19522899 DOI: 10.1111/j.1468-3083.2008.02996.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Formaldehyde-Releasing Preservative in Baby and Cosmetic Products. JOURNAL OF THE DERMATOLOGY NURSES ASSOCIATION 2009. [DOI: 10.1097/jdn.0b013e3181a87888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Czarnobilska E, Obtulowicz K, Dyga W, Wsolek-Wnek K, Spiewak R. Contact hypersensitivity and allergic contact dermatitis among school children and teenagers with eczema. Contact Dermatitis 2009; 60:264-9. [DOI: 10.1111/j.1600-0536.2009.01537.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flohr C, Ravenscroft J, English J. Compositae allergy in three children with hand dermatitis. Contact Dermatitis 2008; 59:370-1. [DOI: 10.1111/j.1600-0536.2008.01445.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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