Department of Paediatric Dermatology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK.
Contact Dermatitis. 2011 Oct;65(4):208-12. doi: 10.1111/j.1600-0536.2011.01900.x. Epub 2011 Apr 19.
Allergic contact dermatitis in children is less recognized than in adults. However, recently, allergic contact dermatitis has started to attract more interest as a cause of or contributor to eczema in children, and patch testing has been gaining in recognition as a useful diagnostic tool in this group.
The aim of this analysis was to investigate the results of patch testing of selected children with eczema of various types (mostly atopic dermatitis) attending the Sheffield Children's Hospital, and to assess potential allergens that might elicit allergic contact dermatitis.
We analysed retrospectively the patch test results in 110 children aged between 2 and 18 years, referred to a contact dermatitis clinic between April 2002 and December 2008. We looked at the percentages of relevant positive reactions in boys and girls, by age groups, and recorded the outcome of treatment following patch testing.
One or more positive allergic reactions of current or past relevance was found in 48/110 children (44%; 29 females and 19 males). There were 94 allergy-positive patch test reactions in 110 patients: 81 had a reaction of current or past relevance, 12 had a reaction of unknown relevance, and 1 had reaction that was a cross-reaction. The commonest allergens with present or past relevance were medicaments, plant allergens, house dust mite, nickel, Amerchol® L101 (a lanolin derivative), and 2-bromo-2-nitropropane-1,3-diol. However, finding a positive allergen was not associated with a better clinical outcome.
We have shown that patch testing can identify relevant allergens in 44% of children with eczema. The commonest relevant allergens were medicament allergens, plant allergens, house dust mite, nickel, Amerchol® L101, and 2-bromo-2-nitropropane-1,3-diol. Patch testing can be performed in children as young as 2 years with the proper preparation.
儿童过敏性接触性皮炎比成人少见,但近年来,这种疾病越来越受到关注,认为它是儿童特应性皮炎的病因或加重因素,斑贴试验作为一种有用的诊断工具在该人群中的应用也越来越广泛。
本分析旨在研究我院皮肤科特应性皮炎等各种类型湿疹患儿(大多为特应性皮炎)斑贴试验的结果,并评估可能引起过敏性接触性皮炎的潜在过敏原。
我们回顾性分析了 2002 年 4 月至 2008 年 12 月期间在接触性皮炎诊所就诊的 110 例年龄在 2 至 18 岁的儿童的斑贴试验结果。我们观察了男孩和女孩各年龄组中相关阳性反应的百分比,并记录了斑贴试验后的治疗结果。
在 110 例患儿中,1 例或 1 例以上阳性过敏反应为当前或既往相关,阳性率为 48%(29 例女性和 19 例男性)。110 例患者共出现 94 次阳性斑贴试验反应:81 次为当前或既往相关,12 次为未知相关性,1 次为交叉反应。最常见的当前或既往相关过敏原依次为药物、植物过敏原、屋尘螨、镍、Amerchol® L101(羊毛脂衍生物)和 2-溴-2-硝基-1,3-丙二醇。然而,发现阳性过敏原与临床转归并无相关性。
我们发现,斑贴试验可以在 44%的湿疹患儿中识别出相关过敏原。最常见的相关过敏原依次为药物过敏原、植物过敏原、屋尘螨、镍、Amerchol® L101 和 2-溴-2-硝基-1,3-丙二醇。适当准备后,斑贴试验可用于 2 岁以下儿童。