Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany.
Contact Dermatitis. 2011 Oct;65(4):220-6. doi: 10.1111/j.1600-0536.2011.01930.x. Epub 2011 May 19.
According to clinical impression, extreme patch test reactions (+++) to p-phenylenediamine (PPD) are not uncommon in children.
To investigate the patch test reactivity in children (aged 1-14 years) in comparison with other age groups and other allergens.
A retrospective analysis was performed of data from the German Information Network of Departments of Dermatology, including all patients consecutively patch tested between 1994 and 2004 with PPD, and, for comparison, nickel, fragrance mix I, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The distribution of +, ++ and +++ grades of positive reactions among those with a positive reaction were analysed in five age strata.
We found a strikingly higher proportion of +++ reactions to PPD in children than in all other age groups (p < 0.001). No such difference was observed for the other allergens. The main suspected exposures associated with extreme reactions to PPD in children were hair dyes and 'henna tattoos'.
The high proportion of extreme patch test reactions to PPD, but not to other important allergens, in children reflects intense sensitization, probably because of a high induction dose from PPD-containing 'henna tattoos'. In children with a history of contact allergy to 'henna tattoos' or hair dyes, the standard patch test concentration of PPD 1% should be drastically reduced.
根据临床印象，儿童对苯二胺（PPD）出现极度斑贴试验反应（+++）并不罕见。
与其他年龄组和其他变应原相比，研究儿童（1-14 岁）的斑贴试验反应性。
对德国皮肤病学部门信息网络在 1994 年至 2004 年间连续进行 PPD 斑贴试验的所有患者的数据进行回顾性分析，并进行了镍、香料混合物 I、甲基氯异噻唑啉酮（MCI）/甲基异噻唑啉酮（MI）的比较。分析了在五个年龄组中，阳性反应者中 +、++和 ++++ 级阳性反应的分布。
我们发现儿童对 PPD 的 +++ 反应比例明显高于所有其他年龄组（p<0.001）。而其他变应原则没有这种差异。与儿童 PPD 极度反应相关的主要可疑暴露是染发剂和“指甲花纹身”。
儿童对 PPD 的强烈斑贴试验反应（而非其他重要变应原）比例较高，反映出强烈的致敏作用，可能是因为 PPD 含量较高的“指甲花纹身”所致。在有“指甲花纹身”或染发剂接触过敏史的儿童中，PPD1%的标准斑贴试验浓度应大幅降低。
