Elżbieta Paśnicka, Marek Paśnicki

Contact allergy and allergic contact / dermatitis in children and adolescents with chronic eczema

Żródło: Allergy 67, Suppl. 96 (2012): 452-586 © 2012 John Wiley & Sons A/S

Contact allergy and allergic contact / dermatitis in children and adolescents with chronic eczema

Spiewak, R1; Grubska-Suchanek, E2; Pasnicki, M3; Krakowski, A4; Cisowska, A5 ’Department of Experimental Dermatology and Cosmetology, Jagiellonian University, Krakow, Poland; department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland; 3NZOZ Allerglcus-Dent, Zary, Poland; 4NZOZ Krak-Med, Kolbuszowa, Poland; dermatology Practice, Kamienna Gora, Poland

Background: Patch test is the gold stan­dard of eczema diagnosis in every age group. The prevalence of allergic contact dermatitis (ACD) in children and adoles­cents is comparable to that of atopic der­matitis. The aim of the present study was to analyse the frequency of contact allergy and ACD in children and adolescents with chronic eczema.

Method: KRAK study is a multi-centre patch test study of patients with chronic eczema. Eleven participating Polish derma­tology and allergy centres submit data of all patients patch tested with the Polish Baseline Series (Chemotechnique Diagnos­tics). The series consists of the European Baseline Series plus propolis and palladium – two relevant sensitizers in Polish paediat­ric and adult populations. Among all data submitted in 2011 by the KRAK study group members, 127 patch test results of children (0-13 years-old, N = 64) and adolescents (14-20 years-old, N = 63) were identified and included into the pres­ent study.

Result: Altogether, 127 children and ado­lescents (36 boys and 91 girls) were patch tested in five out of 11 participating cen­tres. At least one positive reaction to hap­tens from the Polish Baseline Series was recorded in 83 patients (65.4%). In 59 patients (46.5%), the tests were considered clinically relevant (i.e. were deemed as the ultimate cause of their eczema). The figures for frequent sensitizers (at least 3% of the study group) are shown in the table below.

No differences in sensitization rates were observed between prepubertal boys and girls (0-13 years-old). Among adolescents, girls were more frequently sensitized to nickel (46.9% vs 14.3% in boys, P = 0.058), while boys were more fre­quently sensitized to Fragrance mix I (28.6% vs 4.1% in girls, P = 0.025). There was also a tendency to more frequent propolis sensitization among boys (both age groups combined: 16.7% vs 6.6% in girls, P = 0.080). Also interestingly, four patients (3.1%) reacted to palladium but not to nickel, suggesting that under mod­ern environmental exposures palladium is not just a mere cross-reactivity to nickel, as believed previously.

Conclusion: Allergic contact dermatitis is a frequent cause of eczema in children and adolescents. These patients are most fre­quently sensitized to metals and cosmetic ingredients. Natural remedies containing balsam of Peru and propolis should be avoided in children with eczema due to fre­quent sensitizations. Palladium and propolis are frequent sensitizers and should be included into routine patch testing of children.