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Allergic Contact Dermatitis in Children: Review of the Past Decade

  • ALLERGIC SKIN DISEASES (L FONACIER, SECTION EDITOR)
  • Published:
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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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References

  1. Jacob SE, and Herro EM. Practical Patch Testing and Chemical Allergens in Contact Dermatitis. Lexington: Springer, 2013. pp 13–20,86,112,113. Print.

  2. Mydlarski PR, Katz AM, Mamelak AJ, et al. Contact Dermatitis. In: Adkinson NF, Yunginger JW, Busse WW, editors. Middleton’s allergy principles and practice. Philadephia: Mosby; 2014. p. 565–79.

    Google Scholar 

  3. Hon KL, Leung AK, Barankin B. Barrier repair therapy in atopic dermatitis: an overview. Am J Clin Dermatol. 2013;14(5):389–99.

    Article  PubMed  Google Scholar 

  4. Gimenez-Arnau A, Maurer M, De La Cuadra J, Maibach H. Immediate contact skin reactions, an update of Contact Urticaria, Contact Urticaria Syndrome and Protein Contact Dermatitis -- "A Never Ending Story". Eur J Dermatol. 2010;20(5):552–62.

    PubMed  Google Scholar 

  5. McFadden J. Immunologic contact urticaria. Immunol Allergy Clin N Am. 2014;34(1):157–67.

    Article  Google Scholar 

  6. Hjorth N, Roed-Peterson J. Occupational protein contact dermatitis in food handlers. Contact Dermatitis. 1976;2:28–42.

    Article  PubMed  CAS  Google Scholar 

  7. Rieman H, Schwarz T, Grabbe S. Pathomechanisms of the eleicitation phase of allergic contact dermatitis. J Dtsch Dermatol Ges. 2003;1(8):613–9.

    Article  Google Scholar 

  8. Janeway C, Travers P, Walport M, Shlomehik M. Immunobiology: the immune system in health and disease. 6th ed. New York: Garland Science Publishing; 2005.

    Google Scholar 

  9. Nijhawen RI, Matic C, Jacob SE. Contact dermatitis: from basics to allergodromes. Pediatr Ann. 2009;38(2):99–108.

    Article  Google Scholar 

  10. Militello G, Jacob SE, Crawford GH. Allergic contact dermatitis in children. Curr Opin Pediatr. 2006;18:385–90.

    Article  PubMed  Google Scholar 

  11. Elsaie ML, Olasz E, Jacob SE. Cytokines and langerhan cells in allergic contact dermatitis. G Ital Dermatol Venereol. 2008;143(3):195–205.

    PubMed  CAS  Google Scholar 

  12. Straus HW. Artificial sensitization of infants to poison ivy. J Allergy. 1931;2(3):137–44.

    Article  Google Scholar 

  13. Weston WL, Weston JA, Kinoshita J, et al. Prevalence of positive epicutaneous tests among infants, children, and adolescents. Pediatrics. 1986;78(6):1070–4.

    PubMed  CAS  Google Scholar 

  14. Bruckner AL, Weston WL, Morelli JG. Does sensitization to contact allergens begin in infancy? Pediatrics. 2000;105(1):e3.

    Article  PubMed  CAS  Google Scholar 

  15. Jacob SE, Brod B, Crawford GH. Clinically relevant patch test reactions in children--a United States based study. Pediatr Dermatol. 2008;25(5):520–7.

    Article  PubMed  Google Scholar 

  16. Zug KA, McGinley-Smith D, Warshaw EM, et al. Contact allergy in children referred for patch testing: North American Contact Dermatitis Group data, 2001-2004. Arch Dermatol. 2008;144(10):1329–36.

    Article  PubMed  CAS  Google Scholar 

  17. Hogeling M, Pratt M. Allergic contact dermatitis in children: the Ottawa hospital patch-testing clinic experience, 1996 to 2006. Dermatitis. 2008;19(2):86–9.

    PubMed  CAS  Google Scholar 

  18. Jacob SE, Herro EM, Sullivan K, Matiz C, Eichenfield L, Hamann C. Safety and efficacy evaluation of TRUE TEST panels 1.1, 2.1, and 3.1 in children and adolescents. Dermatitis. 2011;22(4):204–10.

    PubMed  CAS  Google Scholar 

  19. Jacob SE, Yang A, Herro E, Zhang C. Contact allergens in a pediatric population: association with atopic dermatitis and comparison with other north American referral centers. J Clin Aesthet Dermatol. 2010;3(10):29–35.

    PubMed Central  PubMed  Google Scholar 

  20. Lewis VJ, Statham BN, Chowdhury MM. Allergic contact dermatitis in 191 consecutively patch tested children. Contact Dermatitis. 2004;51(3):155–6.

    Article  PubMed  CAS  Google Scholar 

  21. Heine G, Schnuch A, Uter W, Worm M. Frequency of contact allergy in German children and adolescents patch tested between 1995 and 2002: results from the Information Network of Departments of Dermatology and the German Contact Dermatitis Research Group. Contact Dermatitis. 2004;51(3):111–7.

    Article  PubMed  Google Scholar 

  22. Clayton TH, Wilkinson SM, Rawcliffe C, Pollock B, Clark SM. Allergic contact dermatitis in children: should pattern of dermatitis determine referral? A retrospective study of 500 children tested between 1995 and 2004 in one U.K. centre. Br J Dermatol. 2006;154(1):114–7.

    Article  PubMed  CAS  Google Scholar 

  23. Goon AT, Goh CL. Patch testing of Singapore children and adolescents: our experience over 18 years. Pediatr Dermatol. 2006;23(2):117–20.

    Article  PubMed  Google Scholar 

  24. Beattie PE, Green C, Lowe G, Lewis-Jones MS. Which children should we patch test? Clin Exp Dermatol. 2007;32(1):6–11.

    PubMed  CAS  Google Scholar 

  25. Onder M, Adisen E. Patch test results in a Turkish paediatric population. Contact Dermatitis. 2008;58(1):63–5.

    Article  PubMed  Google Scholar 

  26. Jacob SE, Burk CJ, Connelly EA. Patch testing: another steroid-sparing agent to consider in children. Pediatr Dermatol. 2008;25(1):81–7.

    Article  PubMed  Google Scholar 

  27. de Waard-vander Spek FB, Oranje AP. Patch tests in children with suspected allergic contact dermatitis: a prospective study and review of the literature. Dermatology. 2009;218(2):119–25.

    Article  Google Scholar 

  28. Mailhol C, Lauwers-Cances V, Rancé F, Paul C, Giordano-Labadie F. Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy. 2009;64(5):801–6.

    Article  PubMed  CAS  Google Scholar 

  29. Hammonds LM, Hall VC, Yiannias JA. Allergic contact dermatitis in 136 children patch tested between 2000 and 2006. Int J Dermatol. 2009;48(3):271–4.

    Article  PubMed  Google Scholar 

  30. Belloni Fortina A, Romano I, Peserico A, Eichenfield LF. Contact sensitization in very young children. J Am Acad Dermatol. 2011;65(4):772–9.

    Article  PubMed  Google Scholar 

  31. Kuljanac I, Knežević E, Cvitanović H. Epicutaneous patch test results in children and adults with allergic contact dermatitis in Karlovac county: a retrospective survey. Acta Dermatovenerol Croat. 2011;19(2):91–7.

    PubMed  Google Scholar 

  32. Schena D, Papagrigoraki A, Tessari G, Peroni A, Sabbadini C, Girolomoni G. Allergic contact dermatitis in children with and without atopic dermatitis. Dermatitis. 2012;23(6):275–80.

    Article  PubMed  CAS  Google Scholar 

  33. Silny W, Bartoszak L, Jenerowicz D, Żukiewicz-Sobczak W, Goździewska M. Prevalence of contact allergy in children suffering from atopic dermatitis, seborrhoeic dermatitis and in healthy controls. Ann Agric Environ Med. 2013;20(1):55–60.

    PubMed  Google Scholar 

  34. Worm M, Aberer W, Agathos M, et al. Patch testing in children–recommendations of the German Contact Dermatitis Research Group (DKG). J Dtsch Dermatol Ges. 2007;5(2):107–9.

    Article  PubMed  Google Scholar 

  35. Jacob SE, Steele T, Brod B, Crawford GH. Dispelling the myths behind pediatric patch testing-experience from our tertiary care patch testing centers. Pediatr Dermatol. 2008;25(3):296–300.

    Article  PubMed  Google Scholar 

  36. Matiz C, Hsu JW, Paz Castanedo-Tardan M, Jacob SE. Allergic contact dermatitis in children: a review of international studies. G Ital Dermatol Venereol. 2009;144(5):541–56.

    PubMed  CAS  Google Scholar 

  37. Jacob SE, Breithaupt A. Environmental Exposures- A Pediatric Perspective on Allergic Contact Dermatitis. Skin and, Aging. 2009 Jul:28–36.

  38. Nelson JL, Mowad CM. Allergic Contact Dermatitis: Patch Testing Beyond the TRUE Test. J Clin Aesthet Dermatol. 2010;3(10):36–41.

    PubMed Central  PubMed  Google Scholar 

  39. Pigatto P, Martelli A, Marsili C, Fiocchi A. Contact dermatitis in children. Ital J Pediatr. 2010;36:2.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Sharma VK, Asati DP. Pediatric contact dermatitis. Indian J Dermatol Venereol Leprol. 2010;76(5):514–20.

    Article  PubMed  Google Scholar 

  41. Jacob SE, Miller JM, Herro EM. Treating Atopic Dermatitis: Tips for Maintaining an Effective Epidermal Barrier. Skin and, Aging. 2011 Jan:s3–10.

  42. Fonacier LS, Aquino MR, Mucci T. Current strategies in treating severe contact dermatitis in pediatric patients. Curr Allergy Asthma Rep. 2012;12(6):599–606.

    Article  PubMed  Google Scholar 

  43. “Thimerosal and 2013–2014 Seasonal Flu Vaccines”. Centers for Disease Control and Prevention. CDC, 3 Sep 2013. Web. 12 Dec 2013.

  44. Nijhawan RI, Jacob SE. Connubial dermatitis revisited: mother-to-child contact dermatitis. Dermatitis. 2009;20:55–7.

    PubMed  Google Scholar 

  45. Hsu JW, Matiz C, Jacob SE. Nickel allergy: localized, id, and systemic manifestations in children. Pediatr Dermatol. 2011;28(3):276–80.

    Article  PubMed  Google Scholar 

  46. Nijhawan RI, Molenda M, Zirwas MJ, Jacob SE. Systemic contact dermatitis. Dermatol Clin. 2009;27:355–64.

    Article  PubMed  CAS  Google Scholar 

  47. Szyfelbein Masterpol K, Gottlieb AB, Scheinman PL. Systemic contact dermatitis presenting as lichen planus of the lip. Dermatitis. 2010;21:218–319.

    PubMed  Google Scholar 

  48. Wentworth AB, Yiannias JA, Keeling JH, et al. Trends in patch-test results and allergen changes in the standard series: A Mayo Clinic 5-year retrospective review (January 1, 2006, to December 31, 2010). J Am Acad Dermatol. 2013 Nov 20.

  49. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50–9.

    Article  PubMed  Google Scholar 

  50. Castanedo-Tardana MP, Zug KA. Methylisothiazolinone. Dermatitis. 2013;24(1):2–6.

    Article  PubMed  CAS  Google Scholar 

  51. Jacob SE, Stechschulte S. Eyelid dermatitis associated with balsam of Peru constituents: benzoic acid and benzyl alcohol. Contact Dermatitis. 2008;58(2):111–2.

    Article  PubMed  Google Scholar 

  52. Morioka Y, Yamasaki K, Leung D, Gallo RL. Cathelicidin antimicrobial peptides inhibit hyaluronan-induced cytokine release and modulate chronic allergic dermatitis. J Immunol. 2008;181(6):3915–22.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  53. Di Nardo A, Braff MH, Taylor KR, et al. Cathelicidin antimicrobial peptides block dendritic cell TLR4 activation and allergic contact sensitization. J Immunol. 2007;178(3):1829–34.

    Article  PubMed  Google Scholar 

  54. Hanifin JM. Filaggrin mutations and allergic contact sensitization. J Invest Dermatol. 2008;128(6):1362–4.

    Article  PubMed  CAS  Google Scholar 

  55. Penna G, Adorini L. 1 Alpha,25-dihydroxyvitamin D3 inhibits differentiation, maturation, activation, and survival of dendritic cells leading to impaired alloreactive T cell activation. J Immunol. 2000;164(5):2405–11.

    Article  PubMed  CAS  Google Scholar 

  56. Uehara M, Sawai T. A longitudinal study of contact sensitivity in patients with atopic dermatitis. Arch Dermatol. 1989;125(3):366–8.

    Article  PubMed  CAS  Google Scholar 

  57. Lobitz Jr WC, Honeyman JF, Winkler NW. Suppressed cell-mediated immunity in two adults with atopic dermatitis. Br J Dermatol. 1972;86(4):317–28.

    Article  PubMed  Google Scholar 

  58. Newell L, Polak ME, Perera J, et al. Sensitization via healthy skin programs Th2 responses in individuals with atopic dermatitis. J Invest Dermatol. 2013;133(10):2372–80.

    Article  PubMed  CAS  Google Scholar 

  59. Lammintausta K, Kalimo K, Fagerlund VL. Patch test reactions in atopic patients. Contact Dermatitis. 1992;26(4):234–40.

    Article  PubMed  CAS  Google Scholar 

  60. Belhadjali H, Mohamed M, Youssef M, Mandhouj S, Chakroun M, Zili J. Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia. Contact Dermatitis. 2008;58(3):188–9.

    Article  PubMed  CAS  Google Scholar 

  61. Oranje AP, Bruynzeel DP, Stenveld HJ, Dieges PH. Immediate- and delayed-type contact hypersensitivity in children older than 5 years with atopic dermatitis: a pilot study comparing different tests. Pediatr Dermatol. 1994;11(3):209–15.

    Article  PubMed  CAS  Google Scholar 

  62. Holden CR, Gawkrodger DJ. 10 years' experience of patch testing with a shoe series in 230 patients: which allergens are important? Contact Dermatitis. 2005;53(1):37–9.

    Article  PubMed  Google Scholar 

  63. Cronin H, Mowad C. Anaphylactic reaction to bacitracin ointment. Cutis. 2009;83(3):127–9.

    PubMed  Google Scholar 

  64. Usmani N, Wilkinson SM. Allergic skin disease: investigation nof both immediate- and delayed-type hypersensitivity is essential. Clin Exp Allergy. 2007;37(10):1541–6.

    PubMed  CAS  Google Scholar 

  65. Roul S, Ducombs G, Taieb A. Usefulness of the European standard series for patch testing in children. A 3-year single-centre study of 337 patients. Contact Dermatitis. 1999;40(5):232–5.

    Article  PubMed  CAS  Google Scholar 

  66. Fisher AA. Childhood allergic contact dermatitis. Cutis. 1975;15:635–42.

    Google Scholar 

  67. Package insert for Thin-Layer Rapid Use Epicutaneous Patch Test (T.R.U.E.)™, Smart Practice; Phoenix, Arizona. February 2012.

  68. Wahlberg JE. Patch testing. In: Rycroft RJG, Menne T, Frosch PJ, Lepoittevin JP, editors. Textbook of contact dermatitis. 3rd ed Berlin: springer-Verlag; 2001. Pp. 435–68.

  69. Anveden I, Lindberg M, Andersen KE, et al. Oral prednisone suppresses allergic but not irritant patch test reactions in individuals hypersensitive to nickel. Contact Dermatitis. 2004;50(5):298–303.

    Article  PubMed  CAS  Google Scholar 

  70. Fowler Jr JF, Maibach HI, Zirwas M, et al. Effects of immunomodulatory agents on patch testing: expert opinion 2012. Dermatitis. 2012;23(6):301–3.

    Article  PubMed  Google Scholar 

  71. Torchia D, Capretti C, Pizzo B, Francalanci S. Patch test triggering recurrence of distant dermatitis: the flare-up phenomenon. CMAJ. 2008;179(4):341.

    Article  PubMed Central  PubMed  Google Scholar 

  72. Fisher AA. Perfume dermatitis in children sensitized to balsam of Peru in topical agents. Cutis. 1990;45(1):21–3.

    PubMed  CAS  Google Scholar 

  73. Gelpi CB, Jacob SE. Instructions for educating patients on ROAT testing in conjunction with patch testing. Dermatol Nurs. 2008;20(2):139–43.

    PubMed  Google Scholar 

  74. Rajagopalan R, Anderson R. Impact of patch testing on dermatology-specific quality of life in patients with allergic contact dermatitis. Am J Contact Dermatitis. 1997;8:215–21.

    Article  PubMed  CAS  Google Scholar 

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Compliance with Ethics Guidelines

Conflict of Interest

Sharon E. Jacob is a board member for the American Contact Dermatitis Society and has served as a consultant for Johnson & Johnson.

Shehla Admani declares that she has no conflict of interest.

Dr. Jacob and Dr. Admani are independent investigators for the PREA-2 study evaluating the safety and efficacy of the 3 panel T.R.U.E. ™ test in children.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Dermatology, Rady Children’s Hospital, University of California San Diego, 8010 Frost Street, Suite 602, San Diego, CA, 92123, USA

    Shehla Admani & Sharon E. Jacob

  2. San Diego and Rady Children’s Hospital, University of California, 8010 Frost Street, Suite 602, San Diego, CA, 92123, USA

    Sharon E. Jacob

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  1. Shehla Admani
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  2. Sharon E. Jacob
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Correspondence to Sharon E. Jacob.

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This article is part of the Topical Collection on Allergic Skin Diseases

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Admani, S., Jacob, S.E. Allergic Contact Dermatitis in Children: Review of the Past Decade. Curr Allergy Asthma Rep 14, 421 (2014). https://doi.org/10.1007/s11882-014-0421-0

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  • DOI: https://doi.org/10.1007/s11882-014-0421-0

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