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Hand eczema in children referred for patch testing: North American Contact Dermatitis Group Data, 2000–2016 *
Author(s) -
Silverberg J.I.,
Warshaw E.M.,
Maibach H.I.,
DeKoven J.G.,
Taylor J.S.,
Atwater A.R.,
Sasseville D.,
Zug K.A.,
Reeder M.J.,
Fowler J.F.,
Pratt M.D.,
Fransway A.F.,
Zirwas M.J.,
Belsito D.V.,
Marks J.G.,
DeLeo V.A.
Publication year - 2021
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19818
Subject(s) - medicine , lanolin , odds ratio , dermatology , patch test , contact dermatitis , irritant contact dermatitis , allergic contact dermatitis , logistic regression , patch testing , allergen , retrospective cohort study , atopic dermatitis , allergy , immunology , chemistry , organic chemistry
Summary Background Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE). Objectives To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing. Methods A retrospective analysis (2000–2016) of North American Contact Dermatitis Group data was performed. Results Of 1634 paediatric patients, 237 (14·5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49·4%), atopic dermatitis (37·1%) and irritant contact dermatitis (16·9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56·1% vs. 61·7%; χ 2 ‐test, P = 0·11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium‐15, Compositae mix, thiuram mix, 2‐mercaptobenzathiazole and colophony. The allergens with the highest mean significance‐prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone. Conclusions Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to the proportion found in children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.