Contact Sensitivity of Turkish Children and Adolescents to European Baseline Series Allergens between 2013 and 2023
Keywords:
contact sensitivity, children, pediatric, allergens, patch testingAbstract
Introduction: Raising the numbers of patch testing in suspected children increases the rate of diagnosis of allergic contact dermatitis and the identification of clinically relevant allergens.
Objective: The aim of this study to identify the most frequently observed allergens among Turkish children and adolescents patch tested in 2013-2023.
Methods: The patch test results of 160 patients (age ≤18) were analyzed retrospectively. The frequency of contact allergens and distribution of positive results in terms of gender, age group (children and adolescents), and the presence of atopic dermatitis (AD) were identified.
Results: Forty-nine patients (30.6%), 34 girls and 15 boys, exhibited positive patch test reactions to a minimum of one allergen, and contact sensitivity was statistically significant higher in girls (P=0.034). The 5 most frequent allergens were nickel sulfate (10.6%), methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) (8.1%), cobalt chloride (5.6%), p-phenylenediamine (PPD) (5%), and MI (3.5%). No significant association was observed between patch test positivity and age groups (p>.05). Nickel sulfate sensitivity was significantly higher in girls than boys (P=.043). A positive reaction was detected in 31.3% of patients with AD and in 33.7% of those without (P>.05) and a significant relationship was observed between contact sensitivity to fragrance allergens and AD (P=.046).
Conclusion: Metals and preservatives represent the most frequent allergens in Turkish children and adolescents. Metal sensitivity is expected to decrease as legislation is enforced. Regulatory measures are now required to reduce MI and MCI/MI contact allergy in Turkey.
References
Veien NK, Hattel T, Justesen O, Norholm A. Contact dermatitis in children. Contact Dermatitis. Nov 1982;8(6):373-5. doi:10.1111/j.1600-0536.1982.tb04261.x
Simonsen AB, Deleuran M, Johansen JD, Sommerlund M. Contact allergy and allergic contact dermatitis in children - a review of current data. Contact Dermatitis. Nov 2011;65(5):254-65. doi:10.1111/j.1600-0536.2011.01963.x
Bonitsis NG, Tatsioni A, Bassioukas K, Ioannidis JP. Allergens responsible for allergic contact dermatitis among children: a systematic review and meta-analysis. Contact Dermatitis. May 2011;64(5):245-57. doi:10.1111/j.1600-0536.2010.01860.x
Smith VM, Clark SM, Wilkinson M. Allergic contact dermatitis in children: trends in allergens, 10 years on. A retrospective study of 500 children tested between 2005 and 2014 in one UK centre. Contact Dermatitis. Jan 2016;74(1):37-43. doi:10.1111/cod.12489
Admani S, Jacob SE. Allergic contact dermatitis in children: review of the past decade. Curr Allergy Asthma Rep. Apr 2014;14(4):421. doi:10.1007/s11882-014-0421-0
Kundak S. Patch Test Results of Contact Sensitization in Children Without Atopic Dermatitis: A Single Tertiary Center Experience. Dermatitis. Mar/Apr 2020;31(2):153-156. doi:10.1097/DER.0000000000000530
Onder M, Adisen E. Patch test results in a Turkish paediatric population. Contact Dermatitis. Jan 2008;58(1):63-5. doi:10.1111/j.1600-0536.2007.01171.x
Akan A, Toyran M, Vezir E, et al. The patterns and clinical relevance of contact allergen sensitization in a pediatric population with atopic dermatitis. Turk J Med Sci. 2015;45(6):1207-13. doi:10.3906/sag-1309-62
Yilmaz Z, Ozkaya E. Patch-test results in terms of the recently recommended allergens in children and adolescents: A retrospective cohort study over 22 years from Turkey. Contact Dermatitis. Mar 23 2021;doi:10.1111/cod.13842
Yucel E, Ozceker D. Contact allergen sensitivity in children with contact dermatitis. Turk Arch Pediatr. Jan 2021;56(1):51-56. doi:10.14744/TurkPediatriArs.2020.79577
Wahlber J. Patch testing. In: Raycroft RJG MT, Frosch PJ, et al. eds., ed. 3rd ed. Springer-Verlag; 2001:439-468.
Hanifin JMR, G. Diagnostic futures of atopic dermatitis. Acta Derm Venereol. 1980;Suppl(92):44-47.
Zafrir Y, Trattner A, Hodak E, Eldar O, Lapidoth M, Ben Amitai D. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review. Pediatr Dermatol. Jan 2018;35(1):76-86. doi:10.1111/pde.13333
Warshaw EM, Aschenbeck KA, DeKoven JG, et al. Epidemiology of pediatric nickel sensitivity: Retrospective review of North American Contact Dermatitis Group (NACDG) data 1994-2014. J Am Acad Dermatol. Oct 2018;79(4):664-671. doi:10.1016/j.jaad.2018.02.071
Larsson-Stymne B, Widstrom L. Ear piercing--a cause of nickel allergy in schoolgirls? Contact Dermatitis. Nov 1985;13(5):289-93. doi:10.1111/j.1600-0536.1985.tb02580.x
Turkish Cosmetic Regulation and the Turkish Regulation of Chemicals. https://www.resmigazete.gov.tr/eskiler/2017/06/20170623M1-18.htm. Accessed June 23,2017.
Thyssen JP, Menne T, Liden C, et al. Cobalt release from implants and consumer items and characteristics of cobalt sensitized patients with dermatitis. Contact Dermatitis. Mar 2012;66(3):113-22. doi:10.1111/j.1600-0536.2011.02001.x
Toledo F, Garcia-Bravo B, Fernandez-Redondo V, et al. Patch testing in children with hand eczema. A 5-year multicentre study in Spain. Contact Dermatitis. Oct 2011;65(4):213-9. doi:10.1111/j.1600-0536.2011.01943.x
Bruckner AL, Weston WL, Morelli JG. Does sensitization to contact allergens begin in infancy? Pediatrics. Jan 2000;105(1):e3. doi:10.1542/peds.105.1.e3
Turkish Medicines and Medical Devices Agency‐Regulatory and Supervisory Authority. Guidelines for the use of preservatives in cosmetic products. . Accessed November 2, 2018, https://titck.gov.tr/storage/legislation/43bb4f2b31306.pdf
Simonsen AB, Deleuran M, Mortz CG, Johansen JD, Sommerlund M. Allergic contact dermatitis in Danish children referred for patch testing - a nationwide multicentre study. Contact Dermatitis. Feb 2014;70(2):104-11. doi:10.1111/cod.12129
Hamann CR, Hamann D, Egeberg A, Johansen JD, Silverberg J, Thyssen JP. Association between atopic dermatitis and contact sensitization: A systematic review and meta-analysis. J Am Acad Dermatol. Jul 2017;77(1):70-78. doi:10.1016/j.jaad.2017.02.001
Simonsen AB, Johansen JD, Deleuran M, Mortz CG, Sommerlund M. Contact allergy in children with atopic dermatitis: a systematic review. Br J Dermatol. Aug 2017;177(2):395-405. doi:10.1111/bjd.15628
Lubbes S, Rustemeyer T, Sillevis Smitt JH, Schuttelaar ML, Middelkamp-Hup MA. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis. Contact Dermatitis. Mar 2017;76(3):151-159. doi:10.1111/cod.12711
Hamann CR, Bernard S, Hamann D, Hansen R, Thyssen JP. Is there a risk using hypoallergenic cosmetic pediatric products in the United States? J Allergy Clin Immunol. Apr 2015;135(4):1070-1071. doi:10.1016/j.jaci.2014.07.066
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