Patch test results in children and adolescents across Europe Analysis of the ESSCA Networkª 2002-2010

Original

1. Anna Belloni Fortina^1,*, 
2. Susan M. Cooper²,
3. Radoslaw Spiewak³, 
4. Elena Fontana¹,
5. Axel Schnuch⁴ and
6. Wolfgang Uter⁵

DOI: 10.1111/pai.12397

This article is protected by copyright. All rights reserved.

Issue

Pediatric Allergy and Immunology

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

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Keywords:

• allergic contact dermatitis;
• atopic dermatitis;
• children;
• contact allergy;
• epidemiology;
•  ESSCA ;
• patch test;
• sensitization

Abstract

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

6708 patients aged 1-16 years old with suspected allergic contact dermatitis were analysed 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: nickel sulfate, cobalt chloride and potassium dichromate, neomycin sulfate, Myroxylon pereirae resin (balsam of Peru), para-phenylendiamine, 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-phenylendiamine (2.49% vs. 1.3%).

Limitations of the study

Chamber loading is not an exact science and variation may occur between staff and departments. Inter-institution variations in readings can occur. A possible geographical 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 EuropeanPediatric Baseline Series.