Pregledni rad
https://doi.org/10.26800/LV-146-supl1-30
Contact allergic dermatitis in the pediatric population
Dubravka Vuković
orcid.org/0000-0002-6485-6081
*
Marin Ogorevc
orcid.org/0000-0002-3801-1026
Snježana Mardešić
orcid.org/0000-0001-7437-2518
* Dopisni autor.
Sažetak
Contact dermatitis is a common inflammatory skin disease, which can be of an allergic or irritant type. Although children often have irritant contact dermatitis, contact allergic dermatitis (CAD) has long been thought to be rare in this population, due to the immaturity of children’s immune systems. The estimated prevalence of pediatric CAD is 16.5%, but cases are infrequently reported and only 1% to 10% of epicutaneous tests are performed on this population. CAD is a delayed-type hypersensitivity reaction (type IV reaction) induced by exposure of the skin to an allergen, which involves a biphasic cellular immune response. Acute CAD is dominated by erythema, edema, papules, vesicles and intense itching, and most often occurs 24–72 hours after exposure to the
allergen. Chronic CAD is characterized by hyperkeratosis, desquamation, lichenification and cracking of the skin. Although skin changes predominate at the point of contact with the allergen, they are not sharply limited and can spread to other regions. The most common contact allergens in the pediatric population are: nickel, fragrance
mixture I, Peruvian balsam, propylene glycol, cocamidopropyl betaine, bacitracin, neomycin, cobalt, formaldehyde (and substances that release it), methylisothiazolinone and lanolin. New allergens that have been mentioned more and more frequently in the context of pediatric CAD in recent years are: substances in diabetes devices
and electronic devices, in sports protectors, in “slime”, linalool and limonene. The gold standard in diagnostics is the epicutaneous test. Contact irritant dermatitis, bacterial and fungal infections, itching, psoriasis, dyshidrosiform dermatitis, seborrheic dermatitis, juvenile plantar dermatosis and dermatomyositis should be excluded in the
differential diagnosis. The basis of effective treatment of pediatric forms of CAD are: the accuracy of the diagnosis established through epicutaneous testing, the avoidance of potential allergens, and the implementation of preventive measures. In the treatment, anti-inflammatory drugs, such as local corticosteroids and local immunomodulators and compresses are most often used. CAD represents an important problem in pediatric dermatology that requires greater attention and research. It is crucial to consider it in cases of therapeutically resistant atopic dermatitis or dermatitis with atypical distribution in children.
Ključne riječi
CONTACT DERMATITIS; ALLERGIC CONTACT DERMATITIS; ALLERGENS; PATCH TEST
Hrčak ID:
315861
URI
Datum izdavanja:
11.4.2024.
Posjeta: 839 *