ABSTRACT
Allergic contact dermatitis occurs frequently in children. Patch testing is needed to identify the responsible allergens and should be performed in children. We recommend a panel of 12 contact allergens as a standard series in children from 6-12 years. Four additional contact allergens should be tested in case of a positive history or suggestive clinical picture. For patch testing in children, the allergens should be applied for 24 hours and the readings should be performed at 48 and 72 hours. Standardized patch testing makes it possible to systematically investigate allergic contact dermatitis and identify relevant allergens in children.
Subject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis/diagnosis , Dermatology/standards , Patch Tests/standards , Pediatrics/standards , Practice Guidelines as Topic , Practice Patterns, Physicians'/standards , Germany , HumansSubject(s)
Allergens/adverse effects , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Occupational/diagnosis , Hand Dermatoses/diagnosis , Propolis/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Diagnosis, Differential , Hand Dermatoses/chemically induced , Humans , Male , Middle Aged , Patch Tests , ShoesABSTRACT
Thiuram mix is tested in the standard series at a test concentration of 1% pet. The single thiurams (DPTD, TMTD, TMTM, TETD), however, are usually tested at 0.25% pet. in Germany. In other countries, the individual components of thiuram mix are tested at 1% pet. The German Contact Dermatitis Research Group (DKG) compared both patch test concentrations in 530 patients in order to find out if (i) a significant number of positive patch tests are missed by testing at the lower concentration, (ii) problems with irritant test reactions occur by increasing the test concentration to 1%, and (iii) the sensitivity of the thiuram mix rises when the breakdown test is done with the higher concentration. Slightly more positive reactions were seen with the higher concentration, but this increase did not reach statistical significance. The reaction index, as a measure for the relation of positive to irritant and/or questionable reactions, remained unchanged for the individual thiurams. The sensitivity of the mix also did not change when the breakdown test was performed with 1% pet. instead of 0.25% pet. Thus, we conclude that both concentrations are of equal diagnostic value in patch testing.
