Premium
Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation
Author(s) -
Bergfors Elisabet,
Inerot Annica,
Falk Lars,
Nyström Ulla,
Trollfors Birger
Publication year - 2019
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.13303
Subject(s) - aluminium , aluminium chloride , medicine , allergy , patch testing , itching , nuclear chemistry , dermatology , contact dermatitis , chemistry , immunology , organic chemistry
Abstract Background According to studies on adults, patch testing with aluminium chloride hexahydrate 2% pet. is insufficient to detect aluminium allergy, and a 10% preparation is recommended. Other studies suggest that a 2% preparation is sufficient for testing children. Objectives To review three previously published Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet. Patients/Methods Altogether, 601 children with persistent itching subcutaneous nodules (granulomas) induced by aluminium‐adsorbed vaccines were patch tested with aluminium chloride hexahydrate 2% pet. and metallic aluminium in (a) a pertussis vaccine trial, (b) clinical practice, and (c) a prospective study. Results Overall, 459 children had positive reactions to the 2% pet. preparation. Another 10 reacted positively only to metallic aluminium. An extreme positive reaction (+++) was seen in 65% of children aged 1 to 2 years as compared with 22% of children aged 7 years. From 8 years onwards, extreme positive reactions were scarce. Conclusions Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children are at risk of extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely in children before the age of 7 to 8 years.