Patch test results in children and adolescents across Europe. Analysis of the ESSCA Network 2002-2010.
BACKGROUND
Contact sensitization in children is more frequent than previously thought.


METHODS
The ESSCA collected patch test data from 11 European countries aggregated to 4 European regions.


RESULTS
Six thousand and eight patients aged 1-16 years old with suspected allergic contact dermatitis were analyzed during a period of 8 years (2002-2010). The overall prevalence of at least one positive reaction to a hapten was 36.9%. The 10 most frequent haptens were as follows: nickel sulfate, cobalt chloride and potassium dichromate, neomycin sulfate, Myroxylon pereirae resin (balsam of Peru), para-phenylenediamine, chloromethylisothiazolinone/methylisothiazolinone 3:1, fragrance mix, lanolin alcohols, and colophony. No difference was found in the prevalence of at least one positive reaction to at least one hapten between boys and girls and between children with atopic dermatitis and children without. Children without atopic dermatitis, when compared with those with, had a significantly higher prevalence of contact sensitization for nickel sulfate (20.91% vs 16.87%, respectively), 4-tert. butylphenol formaldehyde resin (1.61% vs. 0.7%), and para-phenylenediamine (2.49% vs. 1.3%).


CONCLUSIONS
Chamber loading is not an exact science and variation may occur between staff and departments. Interinstitution variations in readings can occur. A possible geographic confounder is that the southern regions tested more children in the younger age group. Relevance was not addressed due to difficulties in the application of a set of uniform definitions.


CONCLUSIONS
Our study adds information on the most common contact allergens detected in children which could help to define a Standard European Pediatric Baseline Series.
Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy.
Anna
A
Belloni Fortina
Department of Dermatology, Churchill Hospital, Oxford, UK.
Susan M
SM
Cooper
Department of Experimental Dermatology and Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland.
Radoslaw
R
Spiewak
Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy.
Elena
E
Fontana
Information Network of Departments of Dermatology (IVDK), University Medicine, Göttingen, Germany.
Axel
A
Schnuch
Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany.
Wolfgang
W
Uter
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006241:Haptens / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D010328:Patch Tests; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies
D006241:Haptens
European Surveillance System on Contact Allergies; allergic contact dermatitis; atopic dermatitis; children; contact allergy; epidemiology; patch test; sensitization