Ortiz Salvador J M, Esteve Martínez A, Subiabre Ferrer D, Victoria Martínez A M, de la Cuadra Oyanguren J, Zaragoza Ninet V
Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
Actas Dermosifiliogr. 2017 Jul-Aug;108(6):571-578. doi: 10.1016/j.ad.2016.12.018. Epub 2017 Mar 8.
Few epidemiological studies have investigated the incidence of allergic contact dermatitis in children. Underdiagnosis has been observed in some studies, with many cases in which the condition is not suspected clinically and patch tests are not performed. However, the prevalence of pediatric sensitization to allergens has been reported to be as high as 20%, and the diagnosis should therefore be contemplated as a possibility in this age group.
We performed a retrospective analysis of the skin allergy database of the Dermatology Department of Consorcio Hospital General Universitario de Valencia. Children between 0 and 16 years of age diagnosed with allergic contact dermatitis in the previous 15 years (between 2000 and 2015) were included in the analysis. Epidemiological (age, sex, history of atopy) and clinical (site of the lesions, allergen series applied, positive reactions, and their relevance) variables were gathered.
Patch tests had been performed on 4,593 patients during the study period. Of these, 265 (6%) were children aged between 0 and 16 years. A positive reaction to at least one of the allergens tested was observed in 144 (54.3%) patients in that group. The allergens most frequently identified were the following (in decreasing order of frequency): thiomersal, cobalt chloride, colophony, paraphenylenediamine, potassium dichromate, mercury, and nickel. The sensitization was considered relevant in 177 (61.3%) cases.
More than half of the children studied showed sensitization to 1 or more allergens, with a high percentage of relevant sensitizations. All children with a clinical suspicion of allergic contact dermatitis should be referred for patch testing. As no standardized test series have been developed for this age group, a high level of clinical suspicion and knowledge of the allergens most commonly involved are required when selecting the allergens to be tested.
很少有流行病学研究调查儿童过敏性接触性皮炎的发病率。一些研究发现存在诊断不足的情况，许多病例在临床上未被怀疑，也未进行斑贴试验。然而，据报道儿童对过敏原致敏的患病率高达20%，因此在这个年龄组应考虑进行该疾病的诊断。
我们对巴伦西亚综合大学医院皮肤科的皮肤过敏数据库进行了回顾性分析。分析纳入了在过去15年（2000年至2015年）被诊断为过敏性接触性皮炎的0至16岁儿童。收集了流行病学（年龄、性别、特应性病史）和临床（皮损部位、应用的过敏原系列、阳性反应及其相关性）变量。
在研究期间对4593例患者进行了斑贴试验。其中，265例（6%）为0至16岁的儿童。该组中有144例（54.3%）患者对至少一种测试过敏原呈阳性反应。最常鉴定出的过敏原如下（按频率递减顺序）：硫柳汞、氯化钴、松香、对苯二胺、重铬酸钾、汞和镍。177例（61.3%）病例的致敏被认为具有相关性。
超过一半的研究儿童对1种或更多种过敏原致敏，且具有相关性致敏的比例很高。所有临床怀疑过敏性接触性皮炎的儿童都应转诊进行斑贴试验。由于尚未为该年龄组开发标准化的测试系列，在选择要测试的过敏原时需要高度的临床怀疑以及对最常涉及的过敏原的了解。
