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Andre N, Usher A, Ofri M, Kilimnik V, Horev A. Examining the benefits of extended patch test series in children: a comprehensive analysis. Int J Dermatol 2024. [PMID: 38411217 DOI: 10.1111/ijd.17103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION The growing presence of allergens in materials and scarce data on allergic contact dermatitis in children has increased our need to refine its diagnosis in this population. We aimed to analyze children's specific responsivity to highly reactive subcomponents of Fragrance mix I, Fragrance mix II, and Textile dye mix from the European baseline series. METHODS We retrospectively analyzed patch test records of children aged 2 to 18 who underwent patch testing with the European baseline series between 2014 and 2022 in Israel. RESULTS A total of 367 children were included in the study. In all, 160 children had positive results; 43 patients reacted to one of the mixes, and 20 performed further testing. Eleven of them completed the extended series at the exact same times as the regular European series, which benefited children. Farnesol was the most reactive compound (30.8%). CONCLUSIONS Performing the extended European series provides a more accurate and time-efficient allergic contact dermatitis diagnosis. Farnesol reactivity appears prominent in children and may justify tighter product regulations.
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Affiliation(s)
- Nicolas Andre
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alisa Usher
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Mai Ofri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | | | - Amir Horev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Dermatology Service, Soroka University Medical Center, Beer Sheva, Israel
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de Oliveira MJS, Bezerra MVF, Loiola RA, de Lima GS, da Rocha GHO, de Oliveira RTD, Barioni ÉD. Effects of slime toy poisoning in children and teenagers. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021357. [DOI: 10.1590/1984-0462/2023/41/2021357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022]
Abstract
Abstract Objective: The aim of this study was to identify which types of skin reactions are associated with slime toys and which of their ingredients are most frequently involved in cases of poisoning. Data source: Between January and July 2021, articles were selected using PubMed, SciELO, and LILACS databases. The following descriptors were used: (dermatitis OR rash OR eczema OR inflammation) AND slime. Inclusion criteria were articles available in full, in either Portuguese, English, or Spanish, published between January 2000 and July 31, 2021, and articles reporting cases of contact dermatitis or eczema potentially or directly attributed to slime toys. Articles not meeting these criteria and duplicate texts in the databases were excluded. Data synthesis: In total, 65 publications were identified, of which 16 were included in this review. This resulted in a total of 22 children (2 males, 20 females), aged between 4 and 13 years, who were reportedly intoxicated by slime toys, most of these being linked to homemade preparations. Studies reported the occurrence of contact or allergic dermatitis on hands, fingers, nails, forearms, and cheeks. The most allergenic and/or irritant ingredients included liquid detergent and soap. Additionally, patch tests identified positive reactions to methylisothiazolinone and methylchloroisothiazolinone, the preservatives used by chemical industries on preparation of glue, soap, detergents, etc. Conclusions: Although slime toys might be important for improving motor development and parental relationships, homemade slime toy recipes include several allergenic and irritant ingredients which might be exposed to vulnerable children and cause intoxications. Therefore, homemade slime toys preparations should be used cautiously and under the supervision of adults.
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Wee C, Tan CH, Zhao X, Yew YW, Goon A. Pattern of contact sensitisation in patients with and without atopic dermatitis in an Asian dermatology centre. Contact Dermatitis 2022; 86:398-403. [PMID: 35133669 DOI: 10.1111/cod.14068] [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: 10/14/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the traditional understanding is that contact sensitisation is less frequent in atopic dermatitis (AD) patients, recent studies have shown similar or higher rates of positive patch test results in AD patients. METHODS This was a single-centre, ten-year retrospective review on contact sensitisation in patients who underwent patch testing between 2007 and 2017. The aims were to characterise the pattern of contact sensitisation and to ascertain a link between contact sensitisation and AD. RESULTS There were 4903 patients (males:females = 1:1.4; mean age 40.1 years old) included. About half (2499, 51.0%) of all patients developed at least one positive reaction. The top five frequent reactions were to nickel sulfate (45.4%), potassium dichromate (16.0%), p-phenylenediamine (13.4%), Myroxylon pereirae (11.8%) and fragrance mix I (11.2%). The overall prevalence of contact sensitisation was not significantly different between patients with or without AD. Patients with AD were less likely to develop contact allergies to budesonide and thiuram mix, and more likely to develop contact allergies to potassium dichromate. CONCLUSIONS Contact sensitisation was detected in 50% of patients patch-tested. Nickel sulfate was the most frequently sensitising allergen. The prevalence of contact allergies in atopic patients is comparable to that in non-atopic patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | | | - Yik Weng Yew
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
| | - Anthony Goon
- National Skin Centre, Singapore.,Lee Kong Chian School of Medicine, Singapore
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Lee EY, Wee CLP, Tan CH, Wee LWY, Lim CEE, Zhao X, Koh MJA, Yew YW, Goon ATJ. Pediatric patch testing in a multi-ethnic Asian population: A retrospective review. Pediatr Dermatol 2022; 39:69-76. [PMID: 34971009 DOI: 10.1111/pde.14904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis (ACD) is increasingly prevalent. Patch testing is the gold-standard diagnostic investigation. The aims of our study were to describe the clinical profile of pediatric patients with ACD in a multi-ethnic Asian population and identify the common contact allergens. METHODS This was a retrospective study involving children and adolescents aged 16 years or younger with clinically suspected ACD who underwent patch testing between January 2007 and March 2020 at two institutions in Singapore. Information pertaining to their demographics, atopy history, clinical presentation, and patch test results was analyzed. RESULTS A total of 252 patients were included. The mean age was 10.9 years (1.0-16.7 years). The majority were Chinese (79.8%) and girls (57.5%). Many (66.3%) had atopic dermatitis (AD), which was mild. The most common presentation was an acral eczematous rash. The sensitization rate was 50.0%. The most frequent reactions were to nickel sulfate (49.2%) and fragrance mix (19.1%). The overall rate of relevant positive patch tests was 72.5%. Patients with AD were less likely to have a reaction to fragrance mix (p = .019) and more likely to have a reaction to disperse blue (p = .041). Compared to younger children, adolescents were less likely to have a positive patch test (p = .008). Indians were also less likely to have a positive reaction (p = .004). CONCLUSION Metals and fragrances were the most common allergens causing childhood ACD in Singapore. Patients with AD were less likely to be sensitized to fragrances and more likely to be sensitized to disperse blue dye.
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Affiliation(s)
- Elis Yuexian Lee
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | | | - Chee Hian Tan
- Department of Dermatology, National Skin Centre, Singapore, Singapore
| | - Lynette Wei Yi Wee
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Charmaine En-En Lim
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Xiahong Zhao
- Research Department, National Skin Centre, Singapore, Singapore
| | - Mark Jean Aan Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yik Weng Yew
- Department of Dermatology, National Skin Centre, Singapore, Singapore.,Research Department, National Skin Centre, Singapore, Singapore
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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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Boonchai W, Chaiyabutr C, Charoenpipatsin N, Sukakul T. Pediatric contact allergy: A comparative study with adults. Contact Dermatitis 2020; 84:34-40. [PMID: 32696982 DOI: 10.1111/cod.13672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis is increasing. The patch test allergens included in pediatric baseline series vary globally. The worldwide prevalence of pediatric reactions to allergens needs clarification. OBJECTIVES Identify the prevalence, associated factors, and culprit allergens for contact allergy among patch-tested Thai children, and compare with those for adults. METHODS Baseline series patch test results from 2010-2019 were collected for patients younger than 18 years of age. As a control group, sex-matched adult patients were randomly selected. The results and characteristics of the two groups were compared. RESULTS The median age of 112 patch tested pediatric patients was 16 (range 2-17) years. Of the children, 35.5% had at least one positive reaction, significantly less than the 56.6% for adults. The five most common pediatric allergens were nickel sulfate (12.1%), potassium dichromate (8.0%), methylisothiazolinone (7.1%), fragrance mix II (6.0%), and carba mix (5.4%). Although similar, the 10 most common allergens of the groups differed in order. Positive reactions to cosmetic allergens were significantly less frequent among the children. Many allergens remained entirely negative. CONCLUSIONS The prevalence of positive reactions was lower in children, varying by population and region. The top-10 pediatric and adult causative allergens were almost identical. We recommend using the same baseline patch test series for children and adults in our region.
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Affiliation(s)
- Waranya Boonchai
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Norramon Charoenpipatsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanisorn Sukakul
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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Wootton CI, Sodaly MK, Billamay SX, English JSC, Mayfong M. Patch test results in paediatric patients with atopic dermatitis in Laos. PLoS One 2020; 15:e0231455. [PMID: 32287282 PMCID: PMC7156065 DOI: 10.1371/journal.pone.0231455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/24/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dermatological services in Laos, South East Asia are limited mainly to the capital and patch testing is currently not available, so no data exists regarding the common cutaneous allergens in this population. OBJECTIVES The aim of this study was to document common allergens in paediatric patients with atopic dermatitis attending the allergy clinic in the capital, Vientiane. PATIENTS/MATERIALS/METHODS Fifty paediatric patients with atopic dermatitis were patch tested using TRUE Test® panels 1 to 3 (35 allergens). Readings were taken at Days 2 and 4. RESULTS Twenty-six positive patch tests were recorded on Day 4 in 15 children (30%). The most common allergens were: gold (18%), nickel (10%), formaldehyde (6%) and p-Phenylenediamine (6%). Other positive allergens were potassium dichromate (2%), cobalt dichloride (2%), Bronopol (2%), paraben mix (2%), fragrance mix 1 (2%) and neomycin (2%). The majority of the patients with positive reactions were female. CONCLUSIONS This study represents the first documented patch test results in the Lao population. It is hoped that these findings will help clinicians to advise the families of children with atopic dermatitis on common allergens to avoid and inform future work on contact dermatitis in this population.
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Affiliation(s)
- Catriona I. Wootton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- * E-mail:
| | - Mong K. Sodaly
- Allergy Clinic, Lao-Korea Childrens’ Hospital, Vientiane, Laos
| | | | | | - Mayxay Mayfong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Laos
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Laos
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Churchill Hospital, Oxford, United Kingdom
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Oosterhaven JAF, Uter W, Aberer W, Armario-Hita JC, Ballmer-Weber BK, Bauer A, Czarnecka-Operacz M, Elsner P, García-Gavín J, Giménez-Arnau AM, John SM, Kręcisz B, Mahler V, Rustemeyer T, Sadowska-Przytocka A, Sánchez-Pérez J, Simon D, Valiukevičienė S, Weisshaar E, Schuttelaar MLA. European Surveillance System on Contact Allergies (ESSCA): Contact allergies in relation to body sites in patients with allergic contact dermatitis. Contact Dermatitis 2019; 80:263-272. [PMID: 30520058 PMCID: PMC6590142 DOI: 10.1111/cod.13192] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/08/2018] [Accepted: 12/02/2018] [Indexed: 12/30/2022]
Abstract
Background Analyses of the European Surveillance System on Contact Allergies (ESSCA) database have focused primarily on the prevalence of contact allergies to the European baseline series, both overall and in subgroups of patients. However, affected body sites have hitherto not been addressed. Objective To determine the prevalence of contact allergies for distinct body sites in patients with allergic contact dermatitis (ACD). Methods Analysis of data collected by the ESSCA (www.essca‐dc.org) in consecutively patch tested patients, from 2009 to 2014, in eight European countries was performed. Cases were selected on the basis of the presence of minimally one positive patch test reaction to the baseline series, and a final diagnosis of ACD attributed to only one body site. Results Six thousand two hundred and fifty‐five cases were analysed. The head and hand were the most common single sites that ACD was attributed to. Differences between countries were seen for several body sites. Nickel, fragrance mix I, cobalt and methylchloroisothiazolinone/methylisothiazolinone were the most frequent allergens reported for various body sites. Conclusions Distinct allergen patterns per body site were observed. However, contact allergies were probably not always relevant for the dermatitis that patients presented with. The possibility of linking positive patch test reactions to relevance, along with affected body sites, should be a useful addition to patch test documentation systems.
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Affiliation(s)
- Jart A F Oosterhaven
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen/Nürnberg, Erlangen, Germany
| | - Werner Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - José C Armario-Hita
- Department of Dermatology, University Hospital of Puerto Real, University of Cádiz, Cádiz, Spain
| | - Barbara K Ballmer-Weber
- Department of Dermatology, University Hospital Zürich and Clinic of Dermatology and Allergology, Kantonsspital St Gallen, Zürich, Switzerland
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, University Allergy Centre, Technical University Dresden, Dresden, Germany
| | | | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Juan García-Gavín
- Department of Dermatology, University Hospital Complex, Faculty of Medicine, A Coruña, Santiago de Compostela; also: Dermatological Office, Vigo, Spain
| | - Ana M Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM Universitat Autònoma, Barcelona, Spain
| | - Swen M John
- Department of Dermatology and Environmental Medicine, Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), Lower Saxony Institute for Occupational Dermatology (NIB), University of Osnabrück, Osnabrück, Germany
| | - Beata Kręcisz
- Faculty of Medicine and Health Science, The Jan Kochanowski University, Kielce, Poland
| | - Vera Mahler
- Department of Dermatology, University of Erlangen/Nürnberg, Erlangen, Bavaria.,Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | | | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Environmental and Occupational Dermatology, University of Heidelberg, Heidelberg, Germany
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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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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Uter W, Werfel T, White IR, Johansen JD. Contact Allergy: A Review of Current Problems from a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061108. [PMID: 29844295 PMCID: PMC6025382 DOI: 10.3390/ijerph15061108] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.
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Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany.
| | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, 30625 Hannover, Germany.
| | - Ian R White
- St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, UK.
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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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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12
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Ascha M, Irfan M, Bena J, Taylor JS, Sood A. Pediatric patch testing: A 10-year retrospective study. Ann Allergy Asthma Immunol 2017; 117:661-667. [PMID: 27979024 DOI: 10.1016/j.anai.2016.09.445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patch testing is the gold standard for diagnosing allergic contact dermatitis in children. OBJECTIVE To present a 10-year retrospective review of pediatric patch testing at our institution. METHODS Data from patients 18 years or younger who presented for patch testing from February 1, 2005, to May 31, 2015, were entered into a database. Patch testing was performed according to North American Contact Dermatitis Group standards. A positive reaction was defined as any allergen for which the patient had a 1+ or greater reaction and provided avoidance information. RESULTS A total of 157 patients with a mean (SD) age of 12.3 (4.1) years were evaluated. The 2 most frequent allergens were nickel and cobalt. Most patients were referred by dermatologists for suspected allergic contact dermatitis (72.3%). Dermatitis was present for more than 2 years in most cases (n = 67 [46.2%]), from 6 months to 2 years (n = 49 [33.8%]), and for less than 6 months (n = 29 [20.0%]). Males were more likely to have a positive reaction to fragrance mix 1 compared with females (P = .02). No significant association was found between age and allergen sensitivity. Those with a history of atopy were more likely to have a positive reaction to cobalt (P = .008) and chromium (P = .03). Sixty patients (38.2%) returned for follow-up, and 37 (60.7%) reported improvement; most (n = 54 [88.5%]) were being treated with topical corticosteroids. CONCLUSION Our study of pediatric patch testing can provide information regarding common allergens in children, which can enhance patient care. Primary care practitioners may benefit from awareness of patch testing as an alternative to prescribing systemic immunosuppressants.
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Affiliation(s)
- Mona Ascha
- Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Mahwish Irfan
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - James Bena
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Apra Sood
- Department of Dermatology, Cleveland Clinic Foundation and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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