Little is known about the epidemiology of allergic contact dermatitis (ACD) in US children. More widespread diagnostic confirmation through epicutaneous patch testing is needed.
The aim was to quantify patch test results from providers evaluating US children.
The study is a retrospective analysis of deidentified patch test results of children aged 18 years or younger, entered by participating providers in the Pediatric Contact Dermatitis Registry, during the first year of data collection (2015–2016).
One thousand one hundred forty-two cases from 34 US states, entered by 84 providers, were analyzed. Sixty-five percent of cases had one or more positive patch test (PPT), with 48% of cases having 1 or more relevant positive patch test (RPPT). The most common PPT allergens were nickel (22%), fragrance mix I (11%), cobalt (9.1%), balsam of Peru (8.4%), neomycin (7.2%), propylene glycol (6.8%), cocamidopropyl betaine (6.4%), bacitracin (6.2%), formaldehyde (5.7%), and gold (5.7%).
This US database provides multidisciplinary information on pediatric ACD, rates of PPT, and relevant RPPT reactions, validating the high rates of pediatric ACD previously reported in the literature. The registry database is the largest comprehensive collection of US-only pediatric patch test cases on which future research can be built. Continued collaboration between patients, health care providers, manufacturers, and policy makers is needed to decrease the most common allergens in pediatric consumer products.
From the *Department of Dermatology, University of California San Diego, La Jolla; †Department of Dermatology, Indiana University Health, Indianapolis; ‡Icahn School of Medicine at Mount Sinai, New York, NY; §Department of Dermatology, University of Utah, Salt Lake City; ∥Department of Pediatrics, Eastern Maine Medical Center, Bangor; ¶College of Medicine, The University of Vermont, Burlington; #Department of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; **Weill Medical College of Cornell University, New York, NY; ††Department of Medicine, State University of New York at Stony Brook, NY; ‡‡Allergy & Immunology Training Program, Winthrop University Hospital, Mineola, NY; §§Department of Dermatology & Cutaneous Surgery, University of Miami, Gables, FL; ∥∥Department of Dermatology and Pediatrics, Emory University School of Medicine, Atlanta, GA; ¶¶Department of Dermatology and Pediatrics, University of Connecticut School of Medicine, Farmington; ##Clinical Dermatology, Northwestern University, Chicago, IL; ***Department of Pediatrics, University of Miami Miller School of Medicine, FL; †††Children’s Specialty Group, Department of Pediatrics and Dermatology, Eastern Virginia Medical School, Norfolk; ‡‡‡Department of Dermatology, Yale School of Medicine, New Haven, CT; §§§Department of Dermatology, University of Colorado Denver; ∥∥∥Denver VAMC, CO; ¶¶¶Vanguard Skin Specialists, Colorado Springs; ###Department of Dermatology, University of California San Diego; ****Department of Dermatology, Medical College of Wisconsin, Milwaukee; ††††Asthma and Allergy Care of Delaware, Newark; ‡‡‡‡Department of Dermatology, University of California San Francisco; §§§§The Everett Clinic, Dermatology Department, WA; ∥∥∥∥Physicians Skin Care, PLLC Louisville, KY, ¶¶¶¶DermResearch, PLLC, Louisville, KY and Icahn School of Medicine at Mount Sinai, NY; ####Department of Dermatology, University of North Carolina, Chapel Hill; *****Department of Dermatology, NYU Ronald O. Perelman School of Medicine, New York, NY; and †††††Department of Dermatology, Loma Linda University, CA.
Address reprint requests to Sharon E. Jacob, MD, Department of Dermatology, Loma Linda University, Faculty Medical Offices, 11370, Anderson St, Suite 2600, Loma Linda, CA 92354. E-mail: email@example.com.
Work performed at: Loma Linda University, Loma Linda CA.
Financial disclosure/conflict of interest: S.E.J. received an American Contact Dermatitis Society Mid-Career Development award to support an education endeavor in information technology acquisition in association with this project. She was the Coordinating Principal Investigator on the PREA-1 and PREA-2 Trials. C.M. was a subinvestigator on the PREA-1 and PREA-2 Trials. K.W. is a contributor to UpToDate but has no conflicts of interest or disclosures for this project. L.F. received Research and Educational Grants (Made to Winthrop University Hospital) from Genentech and Merck. All other authors have no conflicts of interest and no disclosures relevant to this work.
Funding/Support: The provider registry component portion of this study was funded in part by a Society of Pediatric Dermatology Pilot Project Grant.
S.E.J. and A.G. were directly involved in the design, data collection and analysis, conduction of the study, and IRB approvals and preliminary manuscript preparation. The other authors were directly involved in self-reporting their deidentified patch test results and in the preparation and final review of the manuscript. Coauthorship was granted to the investigators who entered more than 15 cases within 1 year of data collection.