title: Pediatric Allergic Contact Dermatitis: Clinical and Epidemiological Study in a Tertiary Hospital.
abstract: BACKGROUND
  Few epidemiological studies have investigated the incidence of allergic contact dermatitis in children. Underdiagnosis has been observed in some studies, with many cases in which the condition is not suspected clinically and patch tests are not performed. However, the prevalence of pediatric sensitization to allergens has been reported to be as high as 20%, and the diagnosis should therefore be contemplated as a possibility in this age group.
  
  
  METHODS
  We performed a retrospective analysis of the skin allergy database of the Dermatology Department of Consorcio Hospital General Universitario de Valencia. Children between 0 and 16 years of age diagnosed with allergic contact dermatitis in the previous 15 years (between 2000 and 2015) were included in the analysis. Epidemiological (age, sex, history of atopy) and clinical (site of the lesions, allergen series applied, positive reactions, and their relevance) variables were gathered.
  
  
  RESULTS
  Patch tests had been performed on 4,593 patients during the study period. Of these, 265 (6%) were children aged between 0 and 16 years. A positive reaction to at least one of the allergens tested was observed in 144 (54.3%) patients in that group. The allergens most frequently identified were the following (in decreasing order of frequency): thiomersal, cobalt chloride, colophony, paraphenylenediamine, potassium dichromate, mercury, and nickel. The sensitization was considered relevant in 177 (61.3%) cases.
  
  
  CONCLUSIONS
  More than half of the children studied showed sensitization to 1 or more allergens, with a high percentage of relevant sensitizations. All children with a clinical suspicion of allergic contact dermatitis should be referred for patch testing. As no standardized test series have been developed for this age group, a high level of clinical suspicion and knowledge of the allergens most commonly involved are required when selecting the allergens to be tested.
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España. Electronic address: Josema.ortiz.salvador@gmail.com.
authors.forename: J M
authors.initials: JM
authors.lastname: Ortiz Salvador
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Esteve Martínez
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: D
authors.initials: D
authors.lastname: Subiabre Ferrer
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Victoria Martínez
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: de la Cuadra Oyanguren
authors.affiliation: Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors.forename: V
authors.initials: V
authors.lastname: Zaragoza Ninet
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004342:Drug Hypersensitivity / Q000453:epidemiology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010328:Patch Tests; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D000485:Allergens
keywords: Alergia cutánea; Allergic contact dermatitis; Dermatitis alérgica de contacto; Dermatología pediátrica; Eczema; Patch tests; Pediatric dermatology; Pruebas epicutáneas; Skin allergy