Pediatria pre prax 3/2016

Contact allergy in children and teenagers

Allergic contact dermatitis (ACD) is an inflammatory skin disease (delayed type hypersenzitivity reaction, mediated by hapten-specific T cells). Substances responsible for the reaction are called haptens. Haptens induce skin inflammation through activation of both innate and acquired specific imunity. In children, the incidence of ACD appears to be on the increase recently. The clinical features of allergic contact dermatitis are itchy eczematous lesions usually at skin sites that have come into contact with alergen. The most important for the right diagnosis is epicutaneous patch testing. Children and adults can be tested with equal concentration of patch test allergens. The most common allergens are reported to be nickel and other metals, topical medicaments, fragrances, preservatives and ruber (thiomersal). The relationship between contact sensitization and atopic dermatitis has been widely discussed but only conflicting data have been reported. The avoidance of the offending allergens is very important. Topical corticosteroids are the common treatment.

Keywords: allergic contact dermatitis, hapten, T cells, epicutaneous patch tests, nickel