Patch test reactions in children, adults and the elderly, A comparative study in patients with suspected allergic contact dermatitis

TLDR

The study examined age‑ and sex‑specific patch test reaction patterns in 234 children, 1200 adults, and 295 elderly patients using a European standard series. Nickel and thimerosal were the most frequent allergens across age groups, with thimerosal dominating in children and adults, nickel more common in older adults, females showing more positive reactions than males, and patch testing recommended for children and elderly patients.

Abstract

The age‐ and sex‐related distribution of positive patch lest reactions was investigated in 234 children (0–7 years, n =72 and 8–14 years, n =162), 1200 adults (20 to 50 years) and 295 elderly patients (≥70 years) with suspected allergic contact dermatitis using a European standard series. In girls Prom 0 to 7 years, the most frequent contact allergens were thimerosal (37.5%) and nickel (27.5%), in girls from 8 to 14 years, nickel (28.7%) and thimerosal (26.6%), in women, thimerosal (25.3%) and nickel (25.2%), and in elderly women, nickel (12.6%) and balsam of Peru (9.7%). The most frequent contact allergens in boys from 0 to 7 years were ethylmercuric chloride (28.1%) and thimerosal (25.0%), in boys from 8 to 14 years, thimerosal (30.9%) and ethylmercuric chloride (14.7%), in men, thimerosal (21.1%) and ethylmercuric chloride (13.7%) and in elderly men, nickel (11.2%) and balsam of Peru (6.7%). Females showed more positive reactions than males. Whilst 0 to 7 year‐old girls and boys showed relatively more frequent reactions, the elderly of both sexes were clearly less affected. Nickel is the most frequent contact allergen in females of 8 years and more. In men, thimerosal is most frequent and reactions to balsam of Peru show a peak incidence in the elderly. Results indicate that patch testing should be considered in children and elderly patients with appropriate indications.