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Contact allergy in children referred for patch testing: North American Contact Dermatitis Group data, 2001-2004.
Arch Dermatol. 2008 Oct; 144(10):1329-36.AD

Abstract

OBJECTIVES

To determine the frequency of positive and relevant patch tests in children referred for patch testing in North America; to compare results of patch testing children and adults; and to compare our results with international data on contact allergy in children.

DESIGN

Retrospective cross-sectional analyses of North American Contact Dermatitis Group (NACDG) data from January 1, 2001, through December 31, 2004. Patch test reactions for allergens that were positive and considered of clinical importance to the patient's eczematous problem were defined as being of current or past relevance.

SETTING

Clinical patch test data from 13 NACDG members, primarily a referral population.

PATIENTS

The pediatric population (hereafter referred to as "children") was defined as patients aged 0 to 18 years (n = 391). Patients 19 years and older constituted the comparison adult group (n = 9670).

MAIN OUTCOME MEASURES

The frequency of positive patch test reactions and number of relevant ones. Secondary measures included the association of atopic markers, frequency of irritant reactions, and sources of relevant supplementary allergens.

RESULTS

No significant difference in the overall frequency of at least 1 relevant positive patch test reaction was noted in children (51.2%) compared with adults (54.1%). The most frequent positive reactions in children were to nickel (28.3%), cobalt chloride (17.9%), thimerosal (15.3%), neomycin sulfate (8.0%), gold sodium thiosulfate (7.7%), and fragrance mix (5.1%). For children aged 0 to 18 the most frequent relevant positive reactions were to nickel sulfate (26.0%), cobalt (12.4%), neomycin (4.4%), fragrance mix (4.1%), gold (3.6%), and quaternium 15 (3.6%). The frequency of irritant reactions in adults and children was similar. Of the children with a relevant positive reaction, 34.0% had atopic dermatitis included as one of their final diagnoses, compared with 11.2% of adults (P < .001). Fifteen percent and 39% of children had relevant allergens not included in the NACDG series and a commercially available skin patch test (T.R.U.E. TEST [thin-layer rapid use epicutaneous test], panel 1.1 and 2.1; Allerderm, Phoenix, Arizona), respectively.

CONCLUSIONS

Adults and children in this group are equally likely to have allergic contact dermatitis; frequency of relevant allergen reactions differs.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Zug KA
Section of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03755, USA. Kathryn.A.Zug@Hitchcock.org
McGinley-Smith D
No affiliation info available
Warshaw EM
No affiliation info available
Taylor JS
No affiliation info available
Rietschel RL
No affiliation info available
Maibach HI
No affiliation info available
Belsito DV
No affiliation info available
Fowler JF
No affiliation info available
Storrs FJ
No affiliation info available
DeLeo VA
No affiliation info available
Marks JG
No affiliation info available
Mathias CG
No affiliation info available
Pratt MD
No affiliation info available
Sasseville D
No affiliation info available

MeSH

AdolescentAdultAge DistributionAllergensChildChild, PreschoolCross-Sectional StudiesDermatitis, Allergic ContactFemaleFollow-Up StudiesHumansIncidenceInfantMaleNorth AmericaPatch TestsRegistriesRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex Distribution

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18936397

Citation

Zug, Kathryn A., et al. "Contact Allergy in Children Referred for Patch Testing: North American Contact Dermatitis Group Data, 2001-2004." Archives of Dermatology, vol. 144, no. 10, 2008, pp. 1329-36.
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.
Zug, K. A., McGinley-Smith, D., Warshaw, E. M., Taylor, J. S., Rietschel, R. L., Maibach, H. I., Belsito, D. V., Fowler, J. F., Storrs, F. J., DeLeo, V. A., Marks, J. G., Mathias, C. G., Pratt, M. D., & Sasseville, D. (2008). Contact allergy in children referred for patch testing: North American Contact Dermatitis Group data, 2001-2004. Archives of Dermatology, 144(10), 1329-36. https://doi.org/10.1001/archderm.144.10.1329
Zug KA, 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. PubMed PMID: 18936397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contact allergy in children referred for patch testing: North American Contact Dermatitis Group data, 2001-2004. AU - Zug,Kathryn A, AU - McGinley-Smith,Daniel, AU - Warshaw,Erin M, AU - Taylor,James S, AU - Rietschel,Robert L, AU - Maibach,Howard I, AU - Belsito,Donald V, AU - Fowler,Joseph F,Jr AU - Storrs,Frances J, AU - DeLeo,Vincent A, AU - Marks,James G,Jr AU - Mathias,C G Toby, AU - Pratt,Melanie D, AU - Sasseville,Denis, PY - 2008/10/22/pubmed PY - 2008/11/18/medline PY - 2008/10/22/entrez SP - 1329 EP - 36 JF - Archives of dermatology JO - Arch Dermatol VL - 144 IS - 10 N2 - OBJECTIVES: To determine the frequency of positive and relevant patch tests in children referred for patch testing in North America; to compare results of patch testing children and adults; and to compare our results with international data on contact allergy in children. DESIGN: Retrospective cross-sectional analyses of North American Contact Dermatitis Group (NACDG) data from January 1, 2001, through December 31, 2004. Patch test reactions for allergens that were positive and considered of clinical importance to the patient's eczematous problem were defined as being of current or past relevance. SETTING: Clinical patch test data from 13 NACDG members, primarily a referral population. PATIENTS: The pediatric population (hereafter referred to as "children") was defined as patients aged 0 to 18 years (n = 391). Patients 19 years and older constituted the comparison adult group (n = 9670). MAIN OUTCOME MEASURES: The frequency of positive patch test reactions and number of relevant ones. Secondary measures included the association of atopic markers, frequency of irritant reactions, and sources of relevant supplementary allergens. RESULTS: No significant difference in the overall frequency of at least 1 relevant positive patch test reaction was noted in children (51.2%) compared with adults (54.1%). The most frequent positive reactions in children were to nickel (28.3%), cobalt chloride (17.9%), thimerosal (15.3%), neomycin sulfate (8.0%), gold sodium thiosulfate (7.7%), and fragrance mix (5.1%). For children aged 0 to 18 the most frequent relevant positive reactions were to nickel sulfate (26.0%), cobalt (12.4%), neomycin (4.4%), fragrance mix (4.1%), gold (3.6%), and quaternium 15 (3.6%). The frequency of irritant reactions in adults and children was similar. Of the children with a relevant positive reaction, 34.0% had atopic dermatitis included as one of their final diagnoses, compared with 11.2% of adults (P < .001). Fifteen percent and 39% of children had relevant allergens not included in the NACDG series and a commercially available skin patch test (T.R.U.E. TEST [thin-layer rapid use epicutaneous test], panel 1.1 and 2.1; Allerderm, Phoenix, Arizona), respectively. CONCLUSIONS: Adults and children in this group are equally likely to have allergic contact dermatitis; frequency of relevant allergen reactions differs. SN - 1538-3652 UR - https://www.unboundmedicine.com/medline/citation/18936397/Contact_allergy_in_children_referred_for_patch_testing:_North_American_Contact_Dermatitis_Group_data_2001_2004_ DB - PRIME DP - Unbound Medicine ER -