title: The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis.
abstract: OBJECTIVE
  Data about contact allergen sensitization (CAS) in children with atopic dermatitis (AD) are limited. The purpose of this study was to identify the frequency and patterns of CAS in children with AD by using a ready-to-use patch test system.
  
  
  METHODS
  After receiving the history of CAS in the patients, the severity of AD and IgE-mediated allergen sensitization were determined.
  
  
  RESULTS
  Of 134 children with AD, 33.8% (n = 45) had at least 1 positive reaction. The most frequent positive reaction was to nickel sulfate (NS) (37.8%, 17/45), followed by methylchloroisothiazolinone (20.0%, 9/45) and thimerosal (15.6%, 7/45). The total Scoring Atopic Dermatitis (SCORAD) score was significantly higher in the NS-sensitized group (P = 0.036). The patients with NS sensitization had moderate-severe AD more frequently than those without any reaction (P = 0.020). When the SCORAD score was evaluated in detail, extent of eczema, score of sleep loss, and pruritus were significantly higher in the patients with NS sensitization than those without any reaction (P = 0.002, P = 0.001, and P = 0.002, respectively).
  
  
  CONCLUSIONS
  Our study confirms the necessity of CAS in the management of AD. In particular, NS sensitization should be considered for children with severe AD or larger extent of eczema and trunk involvement.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Akan
authors.forename: Müge
authors.initials: M
authors.lastname: Toyran
authors.forename: Emine
authors.initials: E
authors.lastname: Vezir
authors.forename: Dilek
authors.initials: D
authors.lastname: Azkur
authors.forename: Ayşenur
authors.initials: A
authors.lastname: Kaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Erkoçoğlu
authors.forename: Ersoy
authors.initials: E
authors.lastname: Civelek
authors.forename: Emine Dibek
authors.initials: ED
authors.lastname: Misirlioğlu
authors.forename: Can Naci
authors.initials: CN
authors.lastname: Kocabaş
mesh_terms: D000485:Allergens / Q000276:immunology*; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications / Q000276:immunology*; D003877:Dermatitis, Contact / Q000276:immunology*; D004485:Eczema / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009532:Nickel / Q000276:immunology; D010328:Patch Tests; D011310:Preservatives, Pharmaceutical; D011537:Pruritus / Q000209:etiology; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D013844:Thiazoles / Q000276:immunology; D013849:Thimerosal / Q000276:immunology
chemical_list: D000485:Allergens; D011310:Preservatives, Pharmaceutical; D013844:Thiazoles; D013849:Thimerosal; C029938:nickel sulfate; D009532:Nickel; C011421:5-chloro-2-methyl-4-isothiazolin-3-one