Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Department of Dermatology, The Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Br J Dermatol. 2021 Jul;185(1):185-194. doi: 10.1111/bjd.19818. Epub 2021 Mar 31.
Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE).
To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing.
A retrospective analysis (2000-2016) of North American Contact Dermatitis Group data was performed.
Of 1634 paediatric patients, 237 (14·5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49·4%), atopic dermatitis (37·1%) and irritant contact dermatitis (16·9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56·1% vs. 61·7%; χ -test, P = 0·11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. The allergens with the highest mean significance-prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone.
Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to the proportion found in children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.
儿童手部湿疹（HE）的病因和相关变应原知之甚少。
描述病因，并确定接受斑贴试验的儿童/青少年（<18 岁）手部湿疹患者的阳性和当前相关变应原的比例。
对北美接触性皮炎组（North American Contact Dermatitis Group）的数据进行回顾性分析（2000-2016 年）。
在 1634 例儿科患者中，有 237 例（14.5%）手部受累。最终的医生诊断包括过敏性接触性皮炎（49.4%）、特应性皮炎（37.1%）和刺激性接触性皮炎（16.9%）。在多变量逻辑回归模型中，就业是唯一与任何手部湿疹或原发性手部湿疹发生几率增加相关的因素。手部湿疹患者与无手部湿疹患者的斑贴试验阳性率相似（56.1% vs. 61.7%；χ 2 检验，P=0.11）。五种最常见的当前相关变应原是镍、甲基异噻唑啉酮、丙二醇、癸基葡萄糖苷和羊毛脂。在 top 20 种相关变应原的多变量逻辑回归模型中，手部湿疹与当前对羊毛脂、季铵盐-15、菊科混合、硫代氨基甲酸盐混合、2-巯基苯并噻唑和松香的反应几率显著增加相关。平均显著性-流行率指数最高的变应原是甲基异噻唑啉酮、卡巴混合物、硫代氨基甲酸盐混合物、镍和甲基氯异噻唑啉酮/甲基异噻唑啉酮。
接受斑贴试验的手部湿疹患儿的斑贴试验阳性率较高，与无手部湿疹患儿的阳性率相似。手部湿疹患儿有明确且相当狭窄的当前相关变应原谱。
