Sensitizing Agents Found in Children and Adolescents with Recalcitrant Atopic Dermatitis: a Cross-sectional Study with a Pediatric Battery

Overview

Journal An Bras Dermatol

Specialty Dermatology

Date 2022 Mar 4

PMID 35241316

Authors

Cristiane Almeida Soares Cattani

Kenselyn Oppermann

Simone Perazzoli

Nathalia Hoffmann Guarda

Paula Barea

Renan Rangel Bonamigo

Affiliations

Soon will be listed here.

Abstract

Background: Atopic dermatitis is the most common inflammatory skin disease in childhood and has an important impact on quality of life, especially severe cases or those that are recalcitrant to treatments. Sensitization to allergens with the potential for allergic contact dermatitis is a factor associated with cases of recalcitrant atopic dermatitis. Understanding the relationship between atopic dermatitis, allergens, and allergic contact dermatitis is essential. In Brazil, there are no studies on sensitization to allergens found in patch tests with pediatric batteries in patients with atopic dermatitis.

Objectives: To verify the main sensitizing agents, the prevalence of allergic contact dermatitis and the epidemiological and clinical profile of children and adolescents with atopic dermatitis.

Methods: Cross-sectional, prospective study in patients between 4 and 18 years of age, with recalcitrant atopic dermatitis, treated at the Sanitary Dermatology Outpatient Clinic (RS). All patients underwent patch tests with a battery of pediatric allergens.

Results: The prevalence of sensitization and allergic contact dermatitis in the evaluated patients was 37.07% (20/54) and 27.7% (15/54), respectively. The most frequent allergens were: nickel sulfate (16.7%), disperse blue (5.6%), and fragrance mix I (5.6%). Nickel was associated with the female sex (p = 0.019).

Study Limitations: Sample size and selection, absence of a control group.

Conclusions: A proportion of patients with recalcitrant atopic dermatitis may be sensitized to different allergens and may even have developed allergic contact dermatitis. Recognizing this context is important in the prevention strategy and management of the disease.

References

Zafrir Y, Trattner A, Hodak E, Eldar O, Lapidoth M, Ben Amitai D . Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. Pediatr Dermatol. 2017; 35(1):76-86. DOI: 10.1111/pde.13333. View

Owen J, Vakharia P, Silverberg J . The Role and Diagnosis of Allergic Contact Dermatitis in Patients with Atopic Dermatitis. Am J Clin Dermatol. 2018; 19(3):293-302. PMC: 5948135. DOI: 10.1007/s40257-017-0340-7. View

Jacob S, Yang A, Herro E, Zhang C . Contact allergens in a pediatric population: association with atopic dermatitis and comparison with other north american referral centers. J Clin Aesthet Dermatol. 2010; 3(10):29-35. PMC: 2958194. View

Herro E, Matiz C, Sullivan K, Hamann C, Jacob S . Frequency of contact allergens in pediatric patients with atopic dermatitis. J Clin Aesthet Dermatol. 2011; 4(11):39-41. PMC: 3225137. View

de Waard-van der Spek F, Darsow U, Mortz C, Orton D, Worm M, Muraro A . EAACI position paper for practical patch testing in allergic contact dermatitis in children. Pediatr Allergy Immunol. 2015; 26(7):598-606. DOI: 10.1111/pai.12463. View

Borok J, Matiz C, Goldenberg A, Jacob S . Contact Dermatitis in Atopic Dermatitis Children-Past, Present, and Future. Clin Rev Allergy Immunol. 2018; 56(1):86-98. DOI: 10.1007/s12016-018-8711-2. View

Ozceker D, Haslak F, Dilek F, Sipahi S, Yucel E, Guler N . Contact sensitization in children with atopic dermatitis. Allergol Immunopathol (Madr). 2018; 47(1):47-51. DOI: 10.1016/j.aller.2018.06.002. View

Simonsen A, Johansen J, Deleuran M, Mortz C, Skov L, Sommerlund M . Children with atopic dermatitis may have unacknowledged contact allergies contributing to their skin symptoms. J Eur Acad Dermatol Venereol. 2017; 32(3):428-436. DOI: 10.1111/jdv.14737. View

Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R . The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series. Pediatr Allergy Immunol. 2010; 22(2):252-6. DOI: 10.1111/j.1399-3038.2010.01075.x. View

10.

Ascha M, Irfan M, Bena J, Taylor J, Sood A . Pediatric patch testing: A 10-year retrospective study. Ann Allergy Asthma Immunol. 2016; 117(6):661-667. DOI: 10.1016/j.anai.2016.09.445. View

11.

Lubbes S, Rustemeyer T, Sillevis Smitt J, Schuttelaar M, Middelkamp-Hup M . Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis. Contact Dermatitis. 2016; 76(3):151-159. DOI: 10.1111/cod.12711. View

12.

Goldenberg A, Mousdicas N, Silverberg N, Powell D, Pelletier J, Silverberg J . Pediatric Contact Dermatitis Registry Inaugural Case Data. Dermatitis. 2016; 27(5):293-302. DOI: 10.1097/DER.0000000000000214. View

13.

Jacob S, McGowan M, Silverberg N, Pelletier J, Fonacier L, Mousdicas N . Pediatric Contact Dermatitis Registry Data on Contact Allergy in Children With Atopic Dermatitis. JAMA Dermatol. 2017; 153(8):765-770. PMC: 5817590. DOI: 10.1001/jamadermatol.2016.6136. View

14.

Mailhol C, Lauwers-Cances V, Rance F, Paul C, Giordano-Labadie F . Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy. 2009; 64(5):801-6. DOI: 10.1111/j.1398-9995.2008.01890.x. View

15.

Felmingham C, Davenport R, Bala H, Palmer A, Nixon R . Allergic contact dermatitis in children and proposal for an Australian Paediatric Baseline Series. Australas J Dermatol. 2019; 61(1):33-38. DOI: 10.1111/ajd.13169. View

16.

Yu J, Atwater A, Brod B, Chen J, Chisolm S, Cohen D . Pediatric Baseline Patch Test Series: Pediatric Contact Dermatitis Workgroup. Dermatitis. 2018; 29(4):206-212. DOI: 10.1097/DER.0000000000000385. View

17.

Teo Y, McFadden J, White I, Lynch M, Banerjee P . Allergic contact dermatitis in atopic individuals: Results of a 30-year retrospective study. Contact Dermatitis. 2019; 81(6):409-416. DOI: 10.1111/cod.13363. View

18.

Tran J, Atwater A, Reeder M . Patch testing in children: not just little adults. Cutis. 2019; 104(5):288-290. View

19.

Rodrigues D, Goulart E . Patch-test results in children and adolescents: systematic review of a 15-year period. An Bras Dermatol. 2016; 91(1):64-72. PMC: 4782649. DOI: 10.1590/abd1806-4841.20163927. View

20.

Akan A, Toyran M, Vezir E, Azkur D, Kaya A, Erkocoglu M . The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis. Turk J Med Sci. 2016; 45(6):1207-13. DOI: 10.3906/sag-1309-62. View