EPICUTANEOUS PATCH TEST RESULTS IN CHILDREN WITH ATOPIC DERMATITIS
Keywords:
atopic dermatitis, contact dermatitis, PATCH test, childrenAbstract
Atopic dermatitis (AD) is one of the most common inflammatory diseases, occurring in 20% of children and 10% of adults in highly developed countries. It is a multifactorial disease with a complex pathogenesis, where a significant role is played by the disruption of the epidermal barrier and immune dysregulation. The wide spectrum of possible clinical manifestations complicates the categorization of these patients. Allergic contact dermatitis (ACD) is not rare in patients with AD. The aim of this study was to evaluate the results of epicutaneous patch testing with a standard series of contact allergens in children with AD and suspected for ACD and to compare the results with disease activity. The study was conducted at the University Clinic for Dermatology, Skopje, in patients with AD, aged ≤18 years. The study included 12 children, 5 girls and 7 boys, aged between 2-13 years. The patch test was negative only in one patient, two patients had only 2 positive results, and 9 patients had 4 or more than 4 positive results. In our series, ACD in children with AD was very common (11 out of 12 patients). The most common allergens were cobalt chloride, potassium dichromate, and propolis 10%.
References
Li H, Zhang Z, Zhang H, Guo Y, Yao Z. Update on the Pathogenesis and Therapy of Atopic Dermatitis. Clin Rev Allergy Immunol. 2021;61:324–338. doi:10.1007/s12016 021 08880 3.
Langan SM, Irvine AD, Weidinger S. Atopic dermatitis [published correction appears in Lancet. 2020 Sep 12;396(10253):758. doi:10.1016/S0140 6736(20)31825 0]. Lancet. 2020;396(10247):345–360. doi:10.1016/S0140 6736(20)31286 1.
Serrano L, Patel KR, Silverberg JI. Association between atopic dermatitis and extracutaneous bacterial and mycobacterial infections: A systematic review and meta-analysis. J Am Acad Dermatol. 2019;80:905–912. doi:10.1016/j.jaad.2018.11.028
Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980:44–47.
Wise F, Sulzberger MB. Footnote on problem of eczema, neurodermatitis and lichenification. In: Wise F, Sulzberger MB, eds. Year Book of Dermatology and Syphilology. Chicago: Year Book Publishers; 1933:38–39.
Neale H, Garza Mayers AC, Tam I, Yu J. Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children. J Am Acad Dermatol. 2021;84(2):235–244. doi:10.1016/j.jaad.2020.11.002.
Reitamo S, Luger TA, Steinhoff M. Textbook of Atopic Dermatitis (1st ed.). CRC Press; 2008. doi:10.3109/9780203091449.
Dizon MP, Yu AM, Singh RK, et al. Systematic review of atopic dermatitis disease definition in studies using routinely collected health data. Br J Dermatol. 2018;178(6):1280–1287. doi:10.1111/bjd.16340.
Johnson H, Aquino MR, Snyder A, et al. Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case–control study. J Am Acad Dermatol. 2023;89(5):1007–1014. doi:10.1016/j.jaad.2023.06.048.
Thyssen JP, Vestergaard C, Deleuran M, et al. European Task Force on Atopic Dermatitis (ETFAD): treatment targets and treatable traits in atopic dermatitis. J Eur Acad Dermatol Venereol. 2020;34(12):e839–e842. doi:10.1111/jdv.16716.
Belloni Fortina A, Romano I, Peserico A, Eichenfield LF. Contact sensitization in very young children. J Am Acad Dermatol. 2011;65(4):772–779.
Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R. A half of schoolchildren with “ISAAC eczema” are ill with allergic contact dermatitis. J Eur Acad Dermatol Venereol. 2011;25(9):1104–1107.
Mortz CG, Lauritsen JM, Bindslev-Jensen C, Andersen KE. Contact allergy and allergic contact dermatitis in adolescents: prevalence measures and associations. Acta Derm Venereol. 2002;82(5):352–358.
Lipozencić J, Wolf R. The diagnostic value of atopy patch testing and prick testing in atopic dermatitis: facts and controversies. Clin Dermatol. 2010;28(1):38–44. doi:10.1016/j.clindermatol.2009.03.008.
Diepgen TL, Ofenloch RF, Bruze M, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–329. doi:10.1111/bjd.14167.
Simonsen AB, Johansen JD, Deleuran M, Mortz CG, Sommerlund M. Contact allergy in children with atopic dermatitis: a systematic review. Br J Dermatol. 2017;177(2):395–405. doi:10.1111/bjd.15628.
Heine G, Schnuch A, Uter W, et al. Type IV sensitization profile of individuals with atopic eczema: results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG). Allergy. 2006;61:611–616. doi:10.1111/j.1398 9995.2006.01029.x
Belhadjali H, Mohamed M, Youssef M, et al. Contact sensitization in atopic dermatitis: results of a prospective study of 89 cases in Tunisia. Contact Dermatitis. 2008;58(3):188–189. doi:10.1111/j.1600 0536.2007.01248.x
Bregnbak D, Johansen JD, Jellesen MS, et al. Chromium allergy and dermatitis: prevalence and main findings. Contact Dermatitis. 2015;73(5):261–280. doi:10.1111/cod.12436.
Malajian D, Belsito DV. Cutaneous delayed type hypersensitivity in patients with atopic dermatitis. J Am Acad Dermatol. 2013;69(2):232–237. doi:10.1016/j.jaad.2013.03.012.
Lundov MD, Krongaard T, Menné TL, Johansen JD. Methylisothiazolinone contact allergy: a review. Br J Dermatol. 2011;165(6):1178–1182. doi:10.1111/j.1365 2133.2011.10523.x.
Jacob SE, Matiz C. Infant clothing snaps as a potential source of nickel exposure. Pediatr Dermatol. 2011;28(3):338–339. doi:10.1111/j.1525 1470.2011.01240.x.
Hu S, Laughter M, Dunnick C. American Contact Dermatitis Society Allergens of the Year 2000 to 2020. Dermatol Clin. 2020;38:doi:10.1016/j.det.2020.02.011.
Johnson H, Aquino MR, Snyder A, Collis RW, Franca K, Goldenberg A, et al. Prevalence of allergic contact dermatitis in children with and without atopic dermatitis: A multicenter retrospective case–control study. J Am Acad Dermatol. 2023;89(5):1007–1014. doi:10.1016/j.jaad.2023.06.048.
Yu J, Atwater AR, Brod B et al. Pediatric Baseline Patch Test Series: Pediatric Contact Dermatitis Workgroup. Dermatitis. 2018;29(4):206–212. doi:10.1097/DER.0000000000000385.
