NEW ORLEANS – Patch testing and prescription of fragrance-free skin care regimens might be indicated for children with moderate to severe atopic dermatitis.
In a study of 101 children, 88% of 54 with atopic dermatitis had a positive patch test result for one or more allergens, compared with 66% of 47 participants without atopic dermatitis, a statistically significant difference.
Dr. Elise Herro
Dr. Elise Herro and her associates also found a correlation regarding the severity of both conditions. "EASI [Eczema Area and Severity Index] scores greater than 10 also statistically correlated with a higher probability of greater than 3 positive patch tests," she said at the annual meeting of the American Contact Dermatitis Society.
Study participants were 6-18 years old. Of the total 101 patients patch tested, 79 had at least one reactive test result. The 54 children classified as atopic met Hanifin-Rajka criteria.
Nickel, balsam of Peru, and fragrance were the most common allergens in the study. Positive reactions were significantly more common in children with atopy versus children without atopy for nickel (35% vs. 26%), balsam of Peru (20% vs. 2%), and fragrance mix (19% vs. 0%).
"We [also] found contact allergens whose high prevalence was unique to our patient population," said Dr. Herro of Rady Children's Hospital and the University of California, San Diego.
Dr. Herro and her colleagues identified children reactive to tixocortol pivalate, and para-tertiary-butylphenol-formaldehyde resin, a component of sports gear that can cause dermatitis. Positive tixocortol pivalate patch test reactions "could be related to the high percentage of atopic patients who have used topical corticosteroids."
Dr. Herro also reviewed previous studies that included patients with both atopic dermatitis and allergic contact dermatitis (Contact Dermatitis 2008;58:188-9; Arch. Dermatol. 2008;144;1329-36; and J. Clin. Aesthet. Dermatol. 2010;3:29-35).
This research "shows us that allergic contact dermatitis is commonly associated with atopic dermatitis, both when you look at frequency of allergic contact dermatitis among patients with atopic dermatitis and the frequency of atopic dermatitis among patients with allergic contact dermatitis," Dr. Herro said.
She said that she had no relevant financial disclosures.