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Age-related differences in patch testing results among children: Analysis of North American Contact Dermatitis Group Data, 2001-2018 - 15/03/22

Doi : 10.1016/j.jaad.2021.07.030 
Jonathan I. Silverberg, MD, PhD, MPH a, b, , Alexander Hou, BS b, Erin M. Warshaw, MD, MS c, d, e, Joel G. DeKoven, MD, MHSc f, Howard I. Maibach, MD g, Donald V. Belsito, MD h, Kathryn A. Zug, MD i, James S. Taylor, MD j, Denis Sasseville, MD k, Cory A. Dunnick, MD l, Marie-Claude Houle, MDCM m, Amber R. Atwater, MD n, Margo J. Reeder, MD o, Vincent A. DeLeo, MD p, Melanie D. Pratt, MD q, Joseph F. Fowler, MD r, Matthew J. Zirwas, MD s, James G. Marks, MD t
a Department of Dermatology, George Washington University School of Medicine, Washington, DC 
b Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 
c Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota 
d Department of Dermatology, University of Minnesota, Minneapolis, Minnesota 
e Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 
f Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada 
g Department of Dermatology, University of California San Francisco, San Francisco, California 
h Department of Dermatology, Columbia University Irving Medical Center, New York, New York 
i Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 
j Department of Dermatology, Cleveland Clinic, Cleveland, Ohio 
k Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada 
l Department of Dermatology, University of Colorado, Aurora, Colorado 
m Division of Dermatology, Centre Hospitalier Universitaire de Quebec, Laval University, Quebec City, Quebec, Canada 
n Department of Dermatology, Duke University Medical Center, Durham, North Carolina 
o Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 
p Department of Dermatology, Keck School of Medicine, Los Angeles, California 
q Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada 
r Division of Dermatology University of Louisville, Louisville, Kentucky 
s Department of Dermatology, Ohio State University, Columbus, Ohio 
t Department of Dermatology, Pennsylvania State University, State College, Hershey, Pennsylvania 

Correspondence and reprint requests to: Jonathan I Silverberg, MD, PhD, MPH, Department of Dermatology, George Washington University, School of Medicine, 2150 Pennsylvania Avenue, Suite 2B-425, Washington DC, 20037.Department of DermatologyGeorge Washington UniversitySchool of Medicine2150 Pennsylvania Avenue, Suite 2B-425WashingtonDC20037

Abstract

Background

An updated understanding of allergic contact dermatitis is needed, particularly in children.

Objectives

To compare positive and clinically relevant reactions in children versus adults referred for patch testing.

Methods

Retrospective analysis of 1871 children and 41,699 adults from the North American Contact Dermatitis Group (NACDG) from 2001-2018.

Results

Both final diagnosis of allergic contact dermatitis (55.2% versus 57.3%; chi square, P = .0716) and prevalence of ≥ 1 currently relevant reaction to a NACDG screening allergen (49.2% vs 52.2%; P = .1178) were similar between children and adults. Currently in children, the most common relevant allergens were nickel sulfate (17.3%), hydroperoxides of linalool (7.8%), methylisothiazolinone (7.7%), cobalt chloride (7.0%), and fragrance mix I (4.9%). Approximately a fifth of children had a positive reaction to a non-NACDG allergen.

Conclusion

Over half of children referred for patch testing were diagnosed with allergic contact dermatitis. The most common relevant allergens in children were nickel sulfate, cobalt chloride, and hydroperoxides of linalool. Twenty percent of children had at least 1 positive reaction to allergens/substances not on the NACDG screening series, underscoring the need for comprehensive testing.

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Key words : adolescent, allergic contact dermatitis, children, dermatitis, epidemiology, health, itch, patch test, pruritus, rash

Abbreviations list : ACD, AD, NACDG, PCP, SPIN


Mappa


 Authors Silverberg and Hou contributed equally to this manuscript.
 Funding sources: None.
 IRB approval status: Approved by the Institutional Review Board at Northwestern University.


© 2021  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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