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Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future

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Abstract

Allergic contact dermatitis (ACD) used to be considered a rarity in children, but recently has been estimated to effect 4.4 million children in the USA alone, with a notable rise in investigative research in the field of pediatric ACD. Researchers have shown that patch testing is safe and effective in afflicted children and that those with atopic dermatitis (AD) have similar sensitization rates, although they have a higher sensitization to certain allergens, thought to be related to the inflammatory (IL-4) milieu. Patch testing assessment guidelines in children include five key considerations: if a patient’s dermatitis worsens, changes distribution, fails to improve with topical therapy, or immediately rebounds after removal of topical treatments; if a patient has a particular distribution of dermatitis; if a working patient has hand eczema that fails to improve with therapy; if the patient has AD that started in adolescence or adulthood with definitely no history of childhood eczema; and importantly, if a patient has severe or widespread atopic dermatitis that will require immunosuppressive systemic medication.

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Abbreviations

CD:

Contact dermatitis

ICD:

Irritant contact dermatitis

ACD:

Allergic contact dermatitis

PPTR:

Positive patch test reaction

AD:

Atopic dermatitis

RPPT:

Relevant positive patch test

NACDG:

The North American Contact Dermatitis Group

PCDR:

The Pediatric Contact Dermatitis Registry

TEWL:

Transepidermal water loss

E.A.S.I.:

Eczema area and severity index

AOY:

Allergen of the Year

TCS:

topical corticosteroids

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Authors and Affiliations

  1. The Mount Sinai Hospital, New York, NY, 10029, USA

    Jenna Borok

  2. Southern California Permanente Medical Group, San Diego, CA, 91367, USA

    Catalina Matiz

  3. Department of Dermatology, University of California San Diego, San Diego, CA, 92122, USA

    Alina Goldenberg

  4. Department of Dermatology, Loma Linda University, Anderson Street, Suite 2600, Loma Linda, CA, 92354, USA

    Sharon E. Jacob

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  1. Jenna Borok
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  2. Catalina Matiz
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  3. Alina Goldenberg
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  4. Sharon E. Jacob
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Correspondence to Sharon E. Jacob.

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Borok, J., Matiz, C., Goldenberg, A. et al. Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future. Clinic Rev Allerg Immunol 56, 86–98 (2019). https://doi.org/10.1007/s12016-018-8711-2

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