Allergic Contact Dermatitis in Children

Abstract

Definition Allergic contact dermatitis (ACD) is an inflammatory reaction of the skin that follows percutaneous absorption of antigen from the skin surface and recruitment of previously sensitized, antigen-specific T lymphocytes into the skin. Epidemiology In the pediatric age group, ACD can involve either sex and manifest as early as the first week of life. A recent review of several European and US studies found that ACD may account for up to 20% of cases of dermatitis in the 0- to 14-year-old age group. Although the incidence and prevalence of the disease in the general pediatric population is unknown, epicutaneous patch testing of randomly selected and otherwise healthy children revealed that 13% to 20% were allergic to one or more common antigens, suggesting that at least 20% of children in the general population theoretically are at risk of developing ACD. When one considers poison ivy or poison oak as contact allergens prevalent in certain areas of North America, the likelihood of allergic contact dermatitis may be much higher. Pediatricians should recognize that children are sensitized to contact allergens early in life, with most children being sensitized by age 5 years. The allergens most commonly responsible for allergic contact dermatitis in North American children are listed in Table 1.