ABSTRACT: Hand eczema is common in children, but affected children are seldom patch tested. Relatively few studies have assessed patch testing in the paediatric population, and none has specifically evaluated its use in hand eczema in children.
The aim of this study was to determine the prevalence of contact allergy in children with hand eczema, and to identify the most frequent allergens and their relevance.
We performed a 5-year retrospective study of children (aged 0-15 years) with hand eczema tested with the Spanish baseline series at the Dermatology Departments of 11 Spanish hospitals.
During the study period, 11 729 patients were patch tested, of whom 480 were children. Hand eczema was present in 111 (23.1%) of the children and in 3437 (30.5%) of the adults. Of the children with hand eczema, 46.8% had at least one positive reaction in the patch tests. Current relevance was found for 78% of the allergens detected. The most common allergens were nickel sulfate, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix I. Allergic contact dermatitis was the most frequent diagnosis (36%), followed by atopic dermatitis.
Allergic contact dermatitis was the most usual diagnosis in our series of children with hand eczema. We recommend patch testing of all children with chronic hand eczema, as is already performed in adults.
Contact Dermatitis 06/2011; 65(4):213-9. · 3.51 Impact Factor
Contact Dermatitis 01/2011; 64(1):58-9. · 3.51 Impact Factor
ABSTRACT: It has been discovered that all individuals who are allergic to cocamidopropyl betaine (CAPB) are sensitized to 3-dimethylaminopropylamine (DMAPA) and to amidoamine, molecules which are intermediaries in CAPB synthesis, and which persist as impurities in the material that is sold; the amounts vary, depending on the quality of the CAPB in the end product. We present three cases of allergic contact dermatitis to DMAPA. In all three cases, the skin tests for DMAPA were positive, while there was no reaction to CAPB. The current relevance of these tests was confirmed by the patients' re-exposure to the suspect products themselves, which contained CAPB. Contact allergy to CAPB is now infrequent, partly because of the increasing use of new non-irritating surfactants that have been introduced on the market in the last decade. However, cases of patients allergic to commercial CAPB who only react to DMAPA -and not to CAPB- when they are patch tested are still being reported. DMAPA itself, and other molecules like amidoamine, would be the true allergens, and some cases of CAPB allergy are therefore being overlooked because DMAPA is not always included in the cosmetics series. CAPB may no longer be necessary in patch tests, as DMAPA seems to be the principal allergenic fraction in this surfactant, and also because manufacturers of skin allergens currently prepare CAPB extracts that are so pure that they are no longer a good screening tool for contact allergy to commercial CAPB.
Actas Dermo-Sifiliográficas 05/2006; 97(3):189-95.