Clinical Reviews in Allergy & Immunology

, Volume 56, Issue 1, pp 86–98 | Cite as

Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future

  • Jenna Borok
  • Catalina Matiz
  • Alina Goldenberg
  • Sharon E. JacobEmail author


Allergic contact dermatitis (ACD) used to be considered a rarity in children, but recently has been estimated to effect 4.4 million children in the USA alone, with a notable rise in investigative research in the field of pediatric ACD. Researchers have shown that patch testing is safe and effective in afflicted children and that those with atopic dermatitis (AD) have similar sensitization rates, although they have a higher sensitization to certain allergens, thought to be related to the inflammatory (IL-4) milieu. Patch testing assessment guidelines in children include five key considerations: if a patient’s dermatitis worsens, changes distribution, fails to improve with topical therapy, or immediately rebounds after removal of topical treatments; if a patient has a particular distribution of dermatitis; if a working patient has hand eczema that fails to improve with therapy; if the patient has AD that started in adolescence or adulthood with definitely no history of childhood eczema; and importantly, if a patient has severe or widespread atopic dermatitis that will require immunosuppressive systemic medication.


Pediatric Allergic contact dermatitis Atopic dermatitis Sensitization Review 



Contact dermatitis


Irritant contact dermatitis


Allergic contact dermatitis


Positive patch test reaction


Atopic dermatitis


Relevant positive patch test


The North American Contact Dermatitis Group


The Pediatric Contact Dermatitis Registry


Transepidermal water loss


Eczema area and severity index


Allergen of the Year


topical corticosteroids


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

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


  1. 1.
    Lim HW, Collins SAB, Resneck JS, Jr., Bolognia JL, Hodge JA, Rohrer TA, et al. The burden of skin disease in the United States. J Am Acad Dermatol. 2017;76(5):958–972.e952Google Scholar
  2. 2.
    Weston WL, Weston JA. Allergic contact dermatitis in children. American journal of diseases of children (1960). 1984;138(10):932–936Google Scholar
  3. 3.
    Hjorth N (1981) Contact dermatitis in children. Acta Derm Venereol Suppl 95:36–39Google Scholar
  4. 4.
    Straus HW (1931) Artificial sensitization of infants to poison ivy. Journal of allergy 2(3):137–144Google Scholar
  5. 5.
    Angelini G, Meneghini C (1977) Contact and bacterial allergy in children with atopic dermatitis. Contact Dermatitis 3(3):163–167Google Scholar
  6. 6.
    Pevny I, Brennenstuhl M, Razinskas G (1984) Patch testing in children. Contact Dermatitis 11(4):201–206Google Scholar
  7. 7.
    Hammershoy O (1980) Standard patch test results in 3,225 consecutive Danish patients from 1973 to 1977. Contact Dermatitis 6(4):263–268Google Scholar
  8. 8.
    Weston JA, Hawkins K, Weston WL (1983) Foot dermatitis in children. Pediatrics 72(6):824–827Google Scholar
  9. 9.
    Leyden JJ, Kligman AM (1979) Contact dermatitis to neomycin sulfate. JAMA 242(12):1276–1278Google Scholar
  10. 10.
    Pevny I, Brennenstuhl M, Razinskas G (1984) Patch testing in children (II). Contact Dermatitis 11(5):302–310Google Scholar
  11. 11.
    Fregert S, Moller H (1963) Contact allergy to balsam of Peru in children. Br J Dermatol 75:218–220Google Scholar
  12. 12.
    Epstein S, Mohajerin AH (1964) Incidence of contact sensitivity in atopic dermatitis. Arch Dermatol 90(3):284–287Google Scholar
  13. 13.
    Weston WL, Weston JA, Kinoshita J, Kloepfer S, Carreon L, Toth S, Bullard D, Harper K, Martinez S (1986) Prevalence of positive epicutaneous tests among infants, children, and adolescents. Pediatrics 78(6):1070–1074Google Scholar
  14. 14.
    Burros MA, Baptista A, Correia T, Azevedo F (1991) Patch testing in children: a study of 562 schoolchildren. Contact Dermatitis 25(3):156–159Google Scholar
  15. 15.
    Bruckner AL, Weston WL, Morelli JG (2000) Does sensitization to contact allergens begin in infancy? Pediatrics 105(1):e3–e3Google Scholar
  16. 16.
    Admani S, Jacob SE (2014) Allergic contact dermatitis in children: review of the past decade. Curr Allergy Asthma Rep 14(4):421Google Scholar
  17. 17.
    Buckley D, Rycroft R, White I, McFadden J (2003) The frequency of fragrance allergy in patch-tested patients increases with their age. Br J Dermatol 149(5):986–989Google Scholar
  18. 18.
    Roul S, Ducombs G, Taieb A (1999) Usefulness of the European standard series for patch testing in children: a 3-year single-centre study of 337 patients. Contact Dermatitis 40(5):232–235Google Scholar
  19. 19.
    Duarte I, Lazzarini R, Kobata CM (2003) Contact dermatitis in adolescents. Dermatitis : contact, atopic, occupational, drug. 14(4):200–204Google Scholar
  20. 20.
    Beattie P, Green C, Lowe G, Lewis-Jones M (2007) Which children should we patch test? Clin Exp Dermatol 32(1):6–11Google Scholar
  21. 21.
    Czarnobilska E, Obtulowicz K, Dyga W, Wsolek-Wnek K, Spiewak R (2009) Contact hypersensitivity and allergic contact dermatitis among school children and teenagers with eczema. Contact Dermatitis 60(5):264–269Google Scholar
  22. 22.
    Jacob SE, Brod B, Crawford GH (2008) Clinically relevant patch test reactions in children—a United States based study. Pediatr Dermatol 25(5):520–527Google Scholar
  23. 23.
    Zug KA, McGinley-Smith D, Warshaw EM, Taylor JS, Rietschel RL, Maibach HI, Belsito DV, Fowler JF Jr, Storrs FJ, DeLeo V, Marks JG Jr, Mathias CG, Pratt MD, Sasseville D (2008) Contact allergy in children referred for patch testing: North American Contact Dermatitis Group data, 2001–2004. Arch Dermatol 144(10):1329–1336Google Scholar
  24. 24.
    Zug KA, Pham AK, Belsito DV, DeKoven JG, DeLeo VA, Fowler JF Jr et al (2014) Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group. Dermatitis : contact, atopic, occupational, drug. 25(6):345–355Google Scholar
  25. 25.
    Belloni Fortina A, Fontana E, Peserico A (2016) Contact sensitization in children: a retrospective study of 2,614 children from a single center. Pediatr Dermatol 33(4):399–404Google Scholar
  26. 26.
    Goldenberg A, Mousdicas N, Silverberg N, Powell D, Pelletier JL, Silverberg JI, Zippin J, Fonacier L, Tosti A, Lawley L, Wu Chang M, Scheman A, Kleiner G, Williams J, Watsky K, Dunnick CA, Frederickson R, Matiz C, Chaney K, Estes TS, Botto N, Draper M, Kircik L, Lugo-Somolinos A, Machler B, Jacob SE (2016) Pediatric contact dermatitis registry inaugural case data. Dermatitis : contact, atopic, occupational, drug. 27(5):293–302Google Scholar
  27. 27.
    Epstein E (1971) Contact dermatitis in children. Pediatr Clin N Am 18(3):839–852Google Scholar
  28. 28.
    Levy A, Hunau D, Foussereau J (1980) Contact dermatitis in children. Contact Dermatitis 6(4):260–262Google Scholar
  29. 29.
    Pigatto P, Martelli A, Marsili C, Fiocchi A (2010) Contact dermatitis in children. Ital J Pediatr 36:2Google Scholar
  30. 30.
    Jacob SE, McGowan M, Silverberg NB, Pelletier JL, Fonacier L, Mousdicas N, et al. Pediatric contact dermatitis registry data on contact allergy in children with atopic dermatitis. JAMA dermatology. 2017Google Scholar
  31. 31.
    Jacob SE (2017) Percutaneous absorption risks in atopic dermatitis. Br J Dermatol 177(1):11–12Google Scholar
  32. 32.
    Darlenski R, Kazandjieva J, Tsankov N, Fluhr JW (2013) Acute irritant threshold correlates with barrier function, skin hydration and contact hypersensitivity in atopic dermatitis and rosacea. Exp Dermatol 22(11):752–753Google Scholar
  33. 33.
    Irvine AD, McLean WI, Leung DY (2011) Filaggrin mutations associated with skin and allergic diseases. N Engl J Med 365(14):1315–1327Google Scholar
  34. 34.
    De Jongh C, Khrenova L, Verberk M, Calkoen F, Van Dijk F, Voss H et al (2008) Loss-of-function polymorphisms in the filaggrin gene are associated with an increased susceptibility to chronic irritant contact dermatitis: a case-control study. Br J Dermatol 159(3):621–627Google Scholar
  35. 35.
    Thyssen JP, Linneberg A, Ross-Hansen K, Carlsen BC, Meldgaard M, Szecsi PB, Stender S, Menné T, Johansen JD (2013) Filaggrin mutations are strongly associated with contact sensitization in individuals with dermatitis. Contact Dermatitis 68(5):273–276Google Scholar
  36. 36.
    Novak N, Baurecht H, Schäfer T, Rodriguez E, Wagenpfeil S, Klopp N, Heinrich J, Behrendt H, Ring J, Wichmann E, Illig T, Weidinger S (2008) Loss-of-function mutations in the filaggrin gene and allergic contact sensitization to nickel. J Investig Dermatol 128(6):1430–1435Google Scholar
  37. 37.
    Thyssen J, McFadden J, Kimber I (2014) The multiple factors affecting the association between atopic dermatitis and contact sensitization. Allergy 69(1):28–36Google Scholar
  38. 38.
    Kaplan DH, Igyártó BZ, Gaspari AA (2012) Early immune events in the induction of allergic contact dermatitis. Nat Rev Immunol 12(2):114–124Google Scholar
  39. 39.
    Gittler JK, Krueger JG, Guttman-Yassky E (2013) Atopic dermatitis results in intrinsic barrier and immune abnormalities: implications for contact dermatitis. J Allergy Clin Immunol 131(2):300–313Google Scholar
  40. 40.
    Dhingra N, Shemer A, da Rosa JC, Rozenblit M, Fuentes-Duculan J, Gittler JK et al (2014) Molecular profiling of contact dermatitis skin identifies allergen-dependent differences in immune response. J Allergy Clin Immunol 134(2):362–372Google Scholar
  41. 41.
    Uehara M, Sawai T (1989) A longitudinal study of contact sensitivity in patients with atopic dermatitis. Arch Dermatol 125(3):366–368Google Scholar
  42. 42.
    Newell L, Polak ME, Perera J, Owen C, Boyd P, Pickard C, Howarth PH, Healy E, Holloway JW, Friedmann PS, Ardern-Jones MR (2013) Sensitization via healthy skin programs Th2 responses in individuals with atopic dermatitis. J Investig Dermatol 133(10):2372–2380Google Scholar
  43. 43.
    Dieli F, Sireci G, Scire E, Salerno A, Bellavia A (1999) Impaired contact hypersensitivity to trinitrochlorobenzene in interleukin-4-deficient mice. Immunology 98:71–79. Google Scholar
  44. 44.
    Machler BC, Sung CT, Darwin E, Jacob SE (2018) Dupilumab use in allergic contact dermatitis. J Am Acad Dermatol.
  45. 45.
    da Rosa JC, Malajian D, Shemer A, Rozenblit M, Dhingra N, Czarnowicki T et al (2015) Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin. J Allergy Clin Immunol 135(3):712–720Google Scholar
  46. 46.
    Cavani A, Pennino D, Eyerich K (2012) Th17 and Th22 in skin allergy. Chemical immunology and allergy 96:39–44Google Scholar
  47. 47.
    Chen JK, Jacob SE, Nedorost ST, Hanifin JM, Simpson EL, Boguniewicz M, Watsky KL, Lugo-Somolinos A, Hamann CR, Eberting CL, Silverberg JI, Thyssen JP (2016) A pragmatic approach to patch testing atopic dermatitis patients: clinical recommendations based on expert consensus opinion. Dermatitis : contact, atopic, occupational, drug. 27(4):186–192Google Scholar
  48. 48.
    Kohli N, Nedorost S. Inflamed skin predisposes to sensitization to less potent allergens. J Am Acad Dermatol. 2016;75(2):312–317.e311Google Scholar
  49. 49.
    Rajka JL, Hanifin JM (1976) Immunodeficiencies in severe atopic dermatitis: depressed chemotaxis and lymphocyte transformation. Arch Dermatol 112(10):1391–1396Google Scholar
  50. 50.
    Thyssen J, Johansen J, Linneberg A, Menné T, Engkilde K (2012) The association between contact sensitization and atopic disease by linkage of a clinical database and a nationwide patient registry. Allergy 67(9):1157–1164Google Scholar
  51. 51.
    Thyssen J, Linneberg A, Engkilde K, Menné T, Johansen J (2012) Contact sensitization to common haptens is associated with atopic dermatitis: new insight. Br J Dermatol 166(6):1255–1261Google Scholar
  52. 52.
    Herro EM, Matiz C, Sullivan K, Hamann C, Jacob SE (2011) Frequency of contact allergens in pediatric patients with atopic dermatitis. The Journal of clinical and aesthetic dermatology 4(11):39–41Google Scholar
  53. 53.
    Rees J, Friedmann PS, Matthews JN (1990) Contact sensitivity to dinitrochlorobenzene is impaired in atopic subjects: controversy revisited. Arch Dermatol 126(9):1173–1175Google Scholar
  54. 54.
    Lever R, Forsyth A (1992) Allergic contact dermatitis in atopic dermatitis. Acta Derm Venereol Suppl 176:95–98Google Scholar
  55. 55.
    Forsbeck M, Hovmark A, Skog E (1976) Patch testing, tuberculin testing and sensitization with dinitrochlorobenzene and nitrosodimethylanilini of patients with atopic dermatitis. Acta Derm Venereol 56(2):135–138Google Scholar
  56. 56.
    Jones HE, Lewis CW, McMarlin SL (1973) Allergic contact sensitivity in atopic dermatitis. Arch Dermatol 107(2):217–222Google Scholar
  57. 57.
    Hamann CR, Bernard S, Hamann D, Hansen R, Thyssen JP (2015) Is there a risk using hypoallergenic cosmetic pediatric products in the United States? J Allergy Clin Immunol 135(4):1070–1071Google Scholar
  58. 58.
    Mailhol C, Lauwers-Cances V, Rance F, Paul C, Giordano-Labadie F (2009) Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy 64(5):801–806Google Scholar
  59. 59.
    Seo KS, Park JY, Terman DS, Bohach GA (2010) A quantitative real time PCR method to analyze T cell receptor Vβ subgroup expansion by staphylococcal superantigens. J Transl Med 8(1):2Google Scholar
  60. 60.
    Aquino M, Fonacier L (2014) The role of contact dermatitis in patients with atopic dermatitis. J Allergy Clin Immunol Pract 2(4):382–387Google Scholar
  61. 61.
    Jacob SE, Goldenberg A, Nedorost S, Thyssen JP, Fonacier L, Spiewak R (2015) Flexural eczema versus atopic dermatitis. Dermatitis : contact, atopic, occupational, drug. 26(3):109–115Google Scholar
  62. 62.
    Allen HB, Vaze ND, Choi C, Hailu T, Tulbert BH, Cusack CA, Joshi SG (2014) The presence and impact of biofilm-producing staphylococci in atopic dermatitis. JAMA dermatology 150(3):260–265Google Scholar
  63. 63.
    Hann S, Hughes T, Stone N (2007) Flexural allergic contact dermatitis to benzalkonium chloride in antiseptic bath oil. Br J Dermatol 157(4):795–798Google Scholar
  64. 64.
    Winnicki M, Shear NH (2011) A systematic approach to systemic contact dermatitis and symmetric drug-related intertriginous and flexural exanthema (SDRIFE). Am J Clin Dermatol 12(3):171–180Google Scholar
  65. 65.
    Panther DJ, Jacob SE (2015) The importance of acidification in atopic eczema: an underexplored avenue for treatment. Journal of clinical medicine. 4(5):970–978Google Scholar
  66. 66.
    Admani S, Matiz C, Jacob SE (2016) Countering Staphylococcus overgrowth during patch testing in children with moderate to severe atopic dermatitis. Pediatr Dermatol 33(1):56–61Google Scholar
  67. 67.
    Whitmore SE (1994) Should atopic individuals be patch tested? Dermatol Clin 12(3):491–499Google Scholar
  68. 68.
    Fortina AB, Romano I, Peserico A, Eichenfield LF (2011) Contact sensitization in very young children. J Am Acad Dermatol 65(4):772–779Google Scholar
  69. 69.
    Malajian D, Belsito DV (2013) Cutaneous delayed-type hypersensitivity in patients with atopic dermatitis. J Am Acad Dermatol 69(2):232–237Google Scholar
  70. 70.
    Belhadjali H, Mohamed M, Youssef M, Mandhouj S, Chakroun M, Zili J (2008) Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia. Contact Dermatitis 58(3):188–189Google Scholar
  71. 71.
    Simonsen AB, Deleuran M, Johansen JD, Sommerlund M (2011) Contact allergy and allergic contact dermatitis in children—a review of current data. Contact Dermatitis 65(5):254–265Google Scholar
  72. 72.
    Jacob SE, Burk CJ, Connelly EA (2008) Patch testing: another steroid-sparing agent to consider in children. Pediatr Dermatol 25(1):81–87Google Scholar
  73. 73.
    Man M-Q, Hatano Y, Lee SH, Man M, Chang S, Feingold KR, Leung DYM, Holleran W, Uchida Y, Elias PM (2008) Characterization of a hapten-induced, murine model with multiple features of atopic dermatitis: structural, immunologic, and biochemical changes following single versus multiple oxazolone challenges. J Investig Dermatol 128(1):79–86Google Scholar
  74. 74.
    Goldenberg A, Silverberg N, Silverberg JI, Treat J, Jacob SE (2015) Pediatric allergic contact dermatitis: lessons for better care. J Allergy Clin Immunol Pract 3(5):661–667Google Scholar
  75. 75.
    Clayton T, Wilkinson S, Rawcliffe C, Pollock B, Clark S (2006) Allergic contact dermatitis in children: should pattern of dermatitis determine referral? A retrospective study of 500 children tested between 1995 and 2004 in one UK centre. Br J Dermatol 154(1):114–117Google Scholar
  76. 76.
    Hill H, Goldenberg A, Golkar L, Beck K, Williams J, Jacob SE (2016) Pre-Emptive Avoidance Strategy (PEAS)–addressing allergic contact dermatitis in pediatric populations. Expert Rev Clin Immunol 12(5):551–561Google Scholar
  77. 77.
    Jacob SE, Herro EM, Sullivan K, Matiz C, Eichenfield L, Hamann C (2011) Safety and efficacy evaluation of TRUE TEST panels 1.1, 2.1, and 3.1 in children and adolescents. Dermatitis : contact, atopic, occupational, drug. 22(4):204–210Google Scholar
  78. 78.
    Jacob SE, Admani S, Herro EM (2014) Invited commentary: recommendation for a North American pediatric patch test series. Curr Allergy Asthma Rep 14(6):1Google Scholar
  79. 79.
    Heine G, Schnuch A, Uter W, Worm M (2004) 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 51(3):111–117Google Scholar
  80. 80.
    Rodrigues DF, Goulart EMA (2016) Patch-test results in children and adolescents: systematic review of a 15-year period. An Bras Dermatol 91(1):64–72Google Scholar
  81. 81.
    Goldenberg A, Lipp M, Jacob SE (2017) Appropriate testing of isothiazolinones in children. Pediatr Dermatol 34(2):138–143Google Scholar
  82. 82.
    Pelletier JL, Perez C, Jacob SE (2016) Contact dermatitis in pediatrics. Pediatr Ann 45(8):e287–e292Google Scholar
  83. 83.
    Fowler JF Jr, Maibach HI, Zirwas M, Taylor JS, DeKoven JG, Sasseville D et al (2012) Effects of immunomodulatory agents on patch testing: expert opinion 2012. Dermatitis : contact, atopic, occupational, drug. 23(6):301–303Google Scholar
  84. 84.
    Isaksson M, Olhardt S, Rådehed J, Svensson Å (2015) Children with atopic dermatitis should always be patch-tested if they have hand or foot dermatitis. Acta Derm Venereol 95(5):583–586Google Scholar
  85. 85.
    Jacob SE, Amini S (2008) Cocamidopropyl betaine. Dermatitis : contact, atopic, occupational, drug 19(3):157–160Google Scholar
  86. 86.
    Beltrani VS, Bernstein IL, Cohen DE, Fonacier L (2006) Contact dermatitis: a practice parameter. Ann Allergy Asthma Immunol 97(3):S1–S38Google Scholar
  87. 87.
    Shaughnessy CN, Malajian D, Belsito DV (2014) Cutaneous delayed-type hypersensitivity in patients with atopic dermatitis: reactivity to surfactants. J Am Acad Dermatol 70(4):704–708Google Scholar
  88. 88.
    Marks Jr JG, DeLeo VA. Contact & occupational dermatology: JP Medical Ltd; 2016Google Scholar
  89. 89.
    Wakelin S, Smith H, White I, Rycroft R, McFadden J (2001) A retrospective analysis of contact allergy to lanolin. Br J Dermatol 145(1):28–31Google Scholar
  90. 90.
    Jacob SE, Steele T (2006) Corticosteroid classes: a quick reference guide including patch test substances and cross-reactivity. J Am Acad Dermatol 54(4):723–727Google Scholar
  91. 91.
    Fortina AB, Romano I, Peserico A (2005) Contact sensitization to Compositae mix in children. J Am Acad Dermatol 53(5):877–880Google Scholar
  92. 92.
    Lu LK, Warshaw EM, Dunnick CA (2009) Prevention of nickel allergy: the case for regulation? Dermatol Clin 27(2):155–161 vi-vii Google Scholar
  93. 93.
    Rasmussen A, Jacob SE. Dandelion: an important allergen in atopic children. Dermatitis : contact, atopic, occupational, drug. 2017;28(2):166Google Scholar
  94. 94.
    Institute N. Materials selection & use. Accessed 10/1/2017
  95. 95.
    Hsu JW, Matiz C, Jacob SE (2011) Nickel allergy: localized, id, and systemic manifestations in children. Pediatr Dermatol 28(3):276–280Google Scholar
  96. 96.
    Silverberg NB, Licht J, Friedler S, Sethi S, Laude TA (2002) Nickel contact hypersensitivity in children. Pediatr Dermatol 19(2):110–113Google Scholar
  97. 97.
    Warshaw EM, Botto NC, Zug KA, Belsito DV, Maibach HI, Sasseville D et al (2008) Contact dermatitis associated with food: retrospective cross-sectional analysis of north American contact dermatitis group data, 2001–2004. Dermatitis : contact, atopic, occupational, drug. 19(5):252–260Google Scholar
  98. 98.
    Fowler JF Jr (2016) Cobalt. Dermatitis : contact, atopic, occupational, drug. 27(1):3–8Google Scholar
  99. 99.
    Gardner KH, Davis MD, Richardson DM, Pittelkow MR (2010) The hazards of moist toilet paper: allergy to the preservative methylchloroisothiazolinone/methylisothiazolinone. Arch Dermatol 146(8):886–890Google Scholar
  100. 100.
    Mowad CM (2000) Methylchloroisothiazolinone revisited. American Journal of Contact Dermatitis 11(2):115–118Google Scholar
  101. 101.
    Lundov MD, Moesby L, Zachariae C, Johansen JD (2009) Contamination versus preservation of cosmetics: a review on legislation, usage, infections, and contact allergy. Contact Dermatitis 60(2):70–78Google Scholar
  102. 102.
    Maier LE, Lampel HP, Bhutani T, Jacob SE (2009) Hand dermatitis: a focus on allergic contact dermatitis to biocides. Dermatol Clin 27(3):251–264Google Scholar
  103. 103.
    Aerts O, Cattaert N, Lambert J, Goossens A (2013) Airborne and systemic dermatitis, mimicking atopic dermatitis, caused by methylisothiazolinone in a young child. Contact Dermatitis 68(4):250–251Google Scholar
  104. 104.
    Aerts O, Baeck M, Constandt L, Dezfoulian B, Jacobs M-C, Kerre S, Lapeere H, Pierret L, Wouters K, Goossens A (2014) The dramatic increase in the rate of methylisothiazolinone contact allergy in Belgium: a multicentre study. Contact Dermatitis 71(1):41–48Google Scholar
  105. 105.
    Yosipovitch G, Maayan-Metzger A, Merlob P, Sirota L (2000) Skin barrier properties in different body areas in neonates. Pediatrics 106(1):105–108Google Scholar
  106. 106.
    Öhman H, Vahlquist A (1998) The pH gradient over the stratum corneum differs in X-linked recessive and autosomal dominant ichthyosis: a clue to the molecular origin of the “acid skin mantle”? J Investig Dermatol 111(4):674–677Google Scholar
  107. 107.
    Ali SM, Yosipovitch G (2013) Skin pH: from basic science to basic skin care. Acta Derm Venereol 93(3):261–269Google Scholar
  108. 108.
    Angelova-Fischer I, Dapic I, Hoek AK, Jakasa I, Fischer TW, Zillikens D, Kezic S (2014) Skin barrier integrity and natural moisturising factor levels after cumulative dermal exposure to alkaline agents in atopic dermatitis. Acta Derm Venereol 94(6):640–644Google Scholar
  109. 109.
    Behne MJ, Meyer JW, Hanson KM, Barry NP, Murata S, Crumrine D, Clegg RW, Gratton E, Holleran WM, Elias PM, Mauro TM (2002) NHE1 regulates the stratum corneum permeability barrier homeostasis microenvironment acidification assessed with fluorescence lifetime imaging. J Biol Chem 277(49):47399–47406Google Scholar
  110. 110.
    Fluhr JW, Elias PM, Man M-Q, Hupe M, Selden C, Sundberg JP, Tschachler E, Eckhart L, Mauro TM, Feingold KR (2010) Is the filaggrin–histidine–urocanic acid pathway essential for stratum corneum acidification? The Journal of investigative dermatology 130(8):2141–2144Google Scholar
  111. 111.
    Korting HC, Hübner K, Greiner K, Hamm G, Braun-Falco O (1990) Differences in the skin surface pH and bacterial microflora due to the long-term application of synthetic detergent preparations of pH 5.5 and pH 7.0. Results of a crossover trial in healthy volunteers. Acta Derm Venereol 70(5):429–431Google Scholar
  112. 112.
    Whiting R, Sackitey S, Calderone S, Morely K, Phillips J (1996) Model for the survival of Staphylococcus aureus in nongrowth environments. Int J Food Microbiol 31(1–3):231–243Google Scholar
  113. 113.
    Schittek B, Hipfel R, Sauer B, Bauer J, Kalbacher H, Stevanovic S, Schirle M, Schroeder K, Blin N, Meier F, Rassner G, Garbe C (2001) Dermcidin: a novel human antibiotic peptide secreted by sweat glands. Nat Immunol 2(12):1133–1137Google Scholar
  114. 114.
    Niyonsaba F, Ogawa H (2005) Protective roles of the skin against infection: implication of naturally occurring human antimicrobial agents β-defensins, cathelicidin LL-37 and lysozyme. J Dermatol Sci 40(3):157–168Google Scholar
  115. 115.
    Chikakane K, Takahashi H (1995) Measurement of skin pH and its significance in cutaneous diseases. Clin Dermatol 13(4):299–306Google Scholar
  116. 116.
    Rippke F, Schreiner V, Schwanitz H-J (2001) The acidic milieu of the horny layer: new findings on the physiology and pathophysiology of skin pH. Am J Clin Dermatol 3(4):261–272Google Scholar
  117. 117.
    Rundle CW, Bergman D, Goldenberg A, Jacob SE (2017) Contact dermatitis considerations in atopic dermatitis. Clin Dermatol 35:367–374Google Scholar
  118. 118.
    Elias PM, Schmuth M (2009) Abnormal skin barrier in the etiopathogenesis of atopic dermatitis. Curr Allergy Asthma Rep 9(4):265–272Google Scholar
  119. 119.
    Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, Guy RH, MacGowan AL, Tazi-Ahnini R, Ward SJ (2009) Epidermal barrier dysfunction in atopic dermatitis. J Investig Dermatol 129(8):1892–1908Google Scholar
  120. 120.
    GRAIS ML (1953) Role of colloidal oatmeal in dermatologic treatment of the aged. AMA archives of dermatology and syphilology 68(4):402–407Google Scholar
  121. 121.
    Panther DJ, Jacob SE (2015) The importance of acidification in atopic eczema: an underexplored avenue for treatment. Journal of clinical medicine 4(5):970–978Google Scholar
  122. 122.
    Kamsteeg M, Jansen P, Vlijmen-Willems V, Van Erp P, Rodijk-Olthuis D, Van Der Valk P et al (2010) Molecular diagnostics of psoriasis, atopic dermatitis, allergic contact dermatitis and irritant contact dermatitis. Br J Dermatol 162(3):568–578Google Scholar
  123. 123.
    Riis JL, Johansen C, Vestergaard C, Bech R, Kragballe K, Iversen L (2011) Kinetics and differential expression of the skin-related chemokines CCL27 and CCL17 in psoriasis, atopic dermatitis and allergic contact dermatitis. Exp Dermatol 20(10):789–794Google Scholar
  124. 124.
    Batra J, Ghosh B (2008) N-acetyltransferases as markers for asthma and allergic/atopic disorders. Curr Drug Metab 9(6):546–553Google Scholar
  125. 125.
    Dupes S. List of cleansers & their pH. Published 2017
  126. 126.
    Shi VY, Tran K, Lio PA (2012) A comparison of physicochemical properties of a selection of modern moisturizers: hydrophilic index and pH. Journal of drugs in dermatology : JDD 11(5):633–636Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jenna Borok
    • 1
  • Catalina Matiz
    • 2
  • Alina Goldenberg
    • 3
  • Sharon E. Jacob
    • 4
    Email author
  1. 1.The Mount Sinai HospitalNew YorkUSA
  2. 2.Southern California Permanente Medical GroupSan DiegoUSA
  3. 3.Department of DermatologyUniversity of California San DiegoSan DiegoUSA
  4. 4.Department of DermatologyLoma Linda UniversityLoma LindaUSA

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