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July 28, 2021
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Consider age, available space in pediatric allergic contact dermatitis patch testing

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Practitioners should take patient age, available space for the patch and allergy frequency into consideration when determining the best option for pediatric patch testing for allergies, according to a research letter.

Allergic contact dermatitis (ACD) is reported to occur in 15% to 25% of the pediatric population, although which allergens to patch test given space limitations is still debated,” Reid W. Collis, BSMAS, of Washington University School of Medicine in St. Louis, and colleagues wrote in the Journal of the American Academy of Dermatology. “Expanded series patch tests have proven efficacious in their ability to more thoroughly evaluate possible etiologies of ACD.”

Researchers analyzed allergy patch tests of 296 children between January 2016 and July 2020 using data from the Pediatric Allergic Contact Dermatitis Registry.

Standard Pediatric Baseline Series and Thin-Layer Rapid Use Epicutaneous Patch tests were used, as were six expanded series patch tests.

The highest percentage detected of the top 10 and top 20 most common allergens was with the North American Comprehensive (NAC)-80 series, which identified 100% and 95%, respectively. Of the top 50 most common allergens, the American Contact Dermatitis Society (ACDS)-80 detected 82%.

The North American Contact Dermatitis Group-70 had the highest percentage of the top 10 and top 20 most common allergens in patients 1 to 5 years old with 70% and 75%, respectively.

For patients 6 to 12 years old, the NAC-80 had the highest percentage with 100% in both the top 10 and top 20 most common allergens.

For those 13 to 17 years old, the NAC-80 had the highest percentage with 90% for the top 10 most common allergens and the ACDS-80 had the highest percentage with 85% for the top 20.

“In an era of pediatric patch testing where a variety of standardized and customized expanded series tests exist, choosing the appropriate panel (or allergens) for a patient is important in ensuring the greatest coverage of likely allergens,” the authors wrote. “While there is no clear ‘best’ patch series, providers should consider the age of the patient, available space to apply patches and frequencies of relevant allergens in determining which patch series to utilize.”