The Mount Sinai Hospital, New York, NY, 10029, USA.
Southern California Permanente Medical Group, San Diego, CA, 91367, USA.
Clin Rev Allergy Immunol. 2019 Feb;56(1):86-98. doi: 10.1007/s12016-018-8711-2.
Allergic contact dermatitis (ACD) used to be considered a rarity in children, but recently has been estimated to effect 4.4 million children in the USA alone, with a notable rise in investigative research in the field of pediatric ACD. Researchers have shown that patch testing is safe and effective in afflicted children and that those with atopic dermatitis (AD) have similar sensitization rates, although they have a higher sensitization to certain allergens, thought to be related to the inflammatory (IL-4) milieu. Patch testing assessment guidelines in children include five key considerations: if a patient's dermatitis worsens, changes distribution, fails to improve with topical therapy, or immediately rebounds after removal of topical treatments; if a patient has a particular distribution of dermatitis; if a working patient has hand eczema that fails to improve with therapy; if the patient has AD that started in adolescence or adulthood with definitely no history of childhood eczema; and importantly, if a patient has severe or widespread atopic dermatitis that will require immunosuppressive systemic medication.
变应性接触性皮炎（ACD）过去被认为在儿童中较为罕见，但最近估计仅在美国就有 440 万儿童受到影响，小儿 ACD 领域的研究也显著增加。研究人员表明，斑贴试验在患病儿童中是安全且有效的，且特应性皮炎（AD）患儿的致敏率相似，尽管他们对某些过敏原的致敏率更高，这被认为与炎症（IL-4）环境有关。儿童斑贴试验评估指南包括五个关键考虑因素：如果患者的皮炎加重、分布改变、外用治疗无效或在去除外用治疗后立即反弹；如果患者的皮炎具有特定的分布；如果工作中的患者患有手部湿疹，且治疗无效；如果患者的 AD 始于青春期或成年期，且肯定没有儿童期湿疹的病史；重要的是，如果患者患有严重或广泛的特应性皮炎，需要免疫抑制的全身性药物治疗。
