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Allergic contact dermatitis in the pediatric population is more common than previously recognized, with recent prevalence estimates of positive patch test reactions in the range of 14–70% of children patch tested. The aim of this study was to confirm the prevalence of clinically relevant allergic contact dermatitis in children at two referral centers and determine the most common contact allergens. We performed a retrospective case series analysis of 65 symptomatic children (35 girls and 30 boys) aged 1–18 years old who were patch tested over a 5-year period for recalcitrant dermatitis. Positive patch test reactions were noted in 54 of the 65 children (prevalence rate of 83%) to 80 different allergens. Fifty children (77%) had positive reactions which were determined to be of “definite” or “probable” current clinical relevance. We conclude that the diagnosis of allergic contact dermatitis to specific relevant allergens is common in children referred for patch testing and that contact allergy should be considered in all children with recalcitrant dermatitis. With this article, we review the literature and present a US based study regarding the clinical relevance of positive patch test reactions in children. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis is now known to be a common problem in pediatric populations, accounting for up to 20% of all dermatitis seen in children. Seminal studies conducted over the past decade have demonstrated a prevalence rate in the range of 25% to 60% of children referred for epicutaneous patch testing. This patch test procedure is generally accepted as the gold standard in vivo technique to diagnose allergic contact dermatitis. However, the overwhelming majority of research studies to date have been conducted on adult populations. Increasingly, pediatric patients are undergoing patch test procedures with techniques that have been standardized and optimized almost exclusively in adults. With this article, we hope to emphasize common misconceptions and pitfalls encountered with this approach. In addition, we hope to stimulate research interest in this field so as to determine the optimum patch test conditions and techniques for children. [ABSTRACT FROM AUTHOR]