Pattern Of Allergic Contact Dermatitis In School Children In Selayang Hospital, Malaysia

ABSTRACT

Background: Allergic contact dermatitis (ACD) was thought to be infrequent in children. However, there was an increasing number of case reports and cross-sectional studies in the past three decades indicating that ACD is not as rare as previously thought. Understanding the pattern of allergic contact dermatitis in children would help with the diagnosis and prevention of this disease. Aim: This study explored the spectrum of contact allergens in schoolchildren. Methodology: This is a retrospective analysis of all primary and secondary schoolchildren who underwent patch test at the Department of Dermatology, Hospital Selayang, Malaysia between January 2012 and March 2013. Patch tests were performed with European Baseline Series and other additional commercial series from Chemotechnique Diagnostics in IQ chambers. The parameters studied included sites of dermatitis, positive patch test reactions and sources of the allergens. Readings were recorded according to the International Contact Dermatitis Research Group recommendation. Results were analyzed using the SPSS Version 12.0. Results: 84 out of 327 (25.7%) patients who underwent patch tests were primary and secondary schoolchildren. Of the 84 schoolchildren, 60.7% had at least one positive patch test reaction. The most common allergens were preservatives found in cosmetic series (51%), rubber chemicals (47.1%), nickel sulfate (31.3%), fragrances (19.6%) and topical medicaments (19.6%). The majority (86%) of patients with facial dermatitis were positive to allergens in dental series, whereas 41.9% of patients with dermatitis involving the upper limbs and 50% of patients with dermatitis involving the lower limbs had positive patch test to rubber chemicals. Patients with dermatitis involving the trunk mostly had positive patch test to fragrances (50%). Sources of fragrances were mainly found in toiletries, topical medicaments and cosmetics. Discussion: This results of this study were interesting because of the high rate of sensitization to preservatives, mainly paraben mix. There were also high sensitization rates to rubber chemicals, which could be due to contact with rubberized shoes, sports equipment and stationery. Conclusions: Schoolchildren with face, limbs or trunk dermatitis should be patch tested with additional dental, rubber and fragrance series respectively.