Patch testing in children from 2005 to 2012: results from the North American contact dermatitis group.
BACKGROUND
Allergic contact dermatitis is common in children. Epicutaneous patch testing is an important tool for identifying responsible allergens.


OBJECTIVE
The objective of this study was to provide the patch test results from children (aged ≤18 years) examined by the North American Contact Dermatitis Group from 2005 to 2012.


METHODS
This is a retrospective analysis of children patch-tested with the North American Contact Dermatitis Group 65- or 70-allergen series. Frequencies and counts were compared with previously published data (2001-2004) using χ statistics.


CONCLUSIONS
A total of 883 children were tested during the study period. A percentage of 62.3% had ≥1 positive patch test and 56.7% had ≥1 relevant positive patch test. Frequencies of positive patch test and relevant positive patch test reaction were highest with nickel sulfate (28.1/25.6), cobalt chloride (12.3/9.1), neomycin sulfate (7.1/6.6), balsam of Peru (5.7/5.5), and lanolin alcohol 50% petrolatum vehicle (5.5/5.1). The ≥1 positive patch test and ≥1 relevant positive patch test in the children did not differ significantly from adults (≥19 years) or from previously tested children (2001-2004). The percentage of clinically relevant positive patch tests for 27 allergens differed significantly between the children and adults. A total of 23.6% of children had a relevant positive reaction to at least 1 supplemental allergen. Differences in positive patch test and relevant positive patch test frequencies between children and adults as well as test periods confirm the importance of reporting periodic updates of patch testing in children to enhance clinicians' vigilance to clinically important allergens.
From the *Section of Dermatology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; †Geisel School of Medicine at Dartmouth, Hanover, NH; ‡Columbia University Medical Center, New York, NY; §University of Toronto, Ontario, Canada; ∥St Luke's Roosevelt Hospital Center, Columbia University, New York, NY; ¶University of Louisville, KY; #Associates in Dermatology, Fort Myers, FL; **University of California-San Francisco; ††Penn State Milton S. Hershey Medical Center, Hershey, PA; ‡‡Department of Dermatology, Group Health Associates, Cincinatti, OH; §§University of Ottawa, Ontario; ∥∥McGill University Health Centre, Montreal, Quebec, Canada; ¶¶Oregon Health Science University, Portland, OR; ##Cleveland Clinic, OH; ***Department of Dermatology, Minneapolis VA Health Care System, University of Minnesota; and †††Ohio State University, Columbus.
Kathryn A
KA
Zug
Anh Khoa
AK
Pham
Donald V
DV
Belsito
Joel G
JG
DeKoven
Vincent A
VA
DeLeo
Joseph F
JF
Fowler
Anthony F
AF
Fransway
Howard I
HI
Maibach
James G
JG
Marks
C G Toby
CG
Mathias
Melanie D
MD
Pratt
Denis
D
Sasseville
Frances J
FJ
Storrs
James S
JS
Taylor
Erin M
EM
Warshaw
Matthew J
MJ
Zirwas
D000293:Adolescent; D000367:Age Factors; D000485:Allergens; D001453:Balsams; D002648:Child; D002675:Child, Preschool; D003035:Cobalt; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007509:Irritants; D008297:Male; D009532:Nickel; D010328:Patch Tests; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States
D000485:Allergens; D001453:Balsams; D007509:Irritants; D003035:Cobalt; C029938:nickel sulfate; D009532:Nickel; C025080:Peruvian balsam; C018021:cobaltous chloride