Pediatric allergic contact dermatitis. Part 2: Patch testing series, procedure, and unique scenarios

J Am Acad Dermatol. 2021 Feb;84(2):247-255. doi: 10.1016/j.jaad.2020.11.001. Epub 2020 Nov 17.

Abstract

Patch testing is the criterion standard for diagnosing allergic contact dermatitis. Causative allergens differ between children and adults, necessitating the development of pediatric-specific patch test series. The Pediatric Baseline Series was developed in 2018 through expert consensus and includes relevant pediatric allergens that dermatologists can use in practice. Obstacles in patch testing, such as the need for multiple office visits, length of patch application, and avoidance of sweat and water on the testing area, are particularly challenging for the pediatric population, and several strategies are proposed. Aside from formal patch testing, alternatives like the repeat open application test and empiric allergen avoidance can be helpful in children. The key to management of allergic contact dermatitis is allergen avoidance, with emphasis on the need to properly identify causative allergens. Continued data collection through registries allows for a better understanding of the diagnosis and management of pediatric allergic contact dermatitis.

Keywords: ACD; Pediatric Baseline Series; allergens; patch testing; pediatric ACD; pediatric allergic contact dermatitis.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Allergens / administration & dosage*
  • Allergens / adverse effects
  • Allergens / immunology
  • Body Size
  • Caregivers / psychology
  • Child
  • Dermatitis, Allergic Contact / diagnosis*
  • Dermatitis, Allergic Contact / immunology
  • Dermatitis, Allergic Contact / therapy
  • False Positive Reactions
  • Humans
  • Office Visits
  • Patch Tests / methods*
  • Patch Tests / psychology
  • Symptom Flare Up

Substances

  • Allergens