Hand eczema in children referred for patch testing: North American Contact Dermatitis Group Data, 2000-2016

Background Little is known about the aetiologies and relevant allergens in paediatric patients with hand eczema (HE). Objectives To characterize the aetiologies and determine the proportion of positive and currently relevant allergens in children/adolescents (age < 18 years) with HE referred for patch testing. Methods A retrospective analysis (2000-2016) of North American Contact Dermatitis Group data was performed. Results Of 1634 paediatric patients, 237 (14 center dot 5%) had involvement of the hands. Final physician diagnoses included allergic contact dermatitis (49 center dot 4%), atopic dermatitis (37 center dot 1%) and irritant contact dermatitis (16 center dot 9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with HE vs. those without HE had similar proportions of positive patch tests (56 center dot 1% vs. 61 center dot 7%; chi(2)-test, P = 0 center dot 11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. The allergens with the highest mean significance-prevalence index number were methylisothiazolinone, carba mix, thiuram mix, nickel and methylchloroisothiazolinone/methylisothiazolinone. Conclusions Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to the proportion found in children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.