Pediatrics
Pediatrics
Allergic contact dermatitis may account for as many as 20% of all cases of dermatitis in children. Furthermore, reported rates of positive patch tests in children suspected of having allergic contact dermatitis range between 27% and almost 96%. In a recent retrospective review of 1,142 pediatric cases in the United States based on data from the Pediatric Contact Dermatitis Registry, 65% of the cases had a positive patch test, and the finding was relevant in almost half of the cases.
What causes allergic contact dermatitis in pediatric patients?
As in adults, children frequently become sensitized to allergens found in personal hygiene/skin care products, fragrances, topical medicines, clothing, preservatives (MCI/MI), or metal substances such as nickel, cobalt or gold.
What are the common contact allergens for children?
According to recent literature, the most common allergens in the pediatric population are nickel, neomycin, fragrance mix, benzalkonium chloride, wool alcohol (lanolin), formaldehyde, MCI/MI (preservatives), propylene glycol, and tixocortol pivalate. Pediatric sensitization can result from exposure to a variety of different products. Nickel, the most common allergen (20%), is found in everyday items such as coins, jewelry, and even smartphones and gaming devices. Another common allergen, p-phenylenediamine (PPD), is an ingredient in the dye used in black henna tattoos, which are popular at fairs and amusement parks.
How to treat allergic contact dermatitis in children?
The signs of contact dermatitis in children manifest as they do in adults. Frequent rashes appear where the skin has contacted the culprit substance. The only way to diagnose the causative allergen is to perform a patch test. Once the substance is identified, the patient must avoid it to remain symptom-free. Flare-ups may be treated with a short course of low to mid-potency corticosteroid; however, topical medications should not be used long term and do not replace the need for an accurate diagnosis.
Additional resources
Waldman, A. Contact Dermatitis in Children: the top 10 allergens. Pediatric News May 2017
Goldberg A, Mousdicas N, Silverberg N, et al. Pediatric Contact Dermatitis Registry inaugural case data. Dermatitis 2016;72(5):292-302
Hill H, Goldenberg A, Golkar L, et al. Pre-emptive avoidance strategy (P.E.A.S.)—addressing allergic contact dermatitis in pediatric populations. Expert Rev Clin Immunol 2016;12(5):551-561
Jacob SE, Brod BA. Paraphenylenediamine in black henna tattoos: sensitization of toddlers indicates a clear need for legislative action. J Clin Aesthet Dermatol. 2011;4(12):46-47
U.S. Department of Health and Human Services (Household Products Database) https://householdproducts.nlm.nih.gov/
Contact Dermatitis Institute Allergen Database – information on individual allergens
