Allergic Contact Dermatitis in Pediatric Practice

Background:Allergic contact dermatitis (ACD) is prevalent among pediatric population, adolescent and young adults. Patients with ACD experience a lot of sociopsychological and quality-of-life (QoL) difficulties. Children and their caregivers alike are vulnerable to the burden of ACD.

Objective:We have, in this paper, provided an overview of ACD and discussed common and unu-sual causes of ACD.

Methods:We performed an up-to-date literature review in the English language on "allergic contact dermatitis" via PubMed Clinical Queries, using the keywords "allergic contact dermatitis" in Au-gust 2022. The search included meta-analyses, randomized controlled trials, clinical trials, case-control studies, cohort studies, observational studies, clinical guidelines, case series, case reports, and reviews. The search was restricted to English literature and children.

Results:ACD may be acute or chronic and it affects more than 20% of children and adults with significant quality-of-life impairments. ACD is manifested by varying degrees of cutaneous edema, vesiculation, and erythema. The hypersensitivity reaction is one of the most prevalent forms of im-munotoxicity in humans. Localized acute ACD lesions can be managed with high-potency topical steroids; if ACD is severe or extensive, systemic corticosteroid therapy is often required to provide relief within 24 hours. In patients with more severe dermatitis, oral prednisone should be tapered over 2-3 weeks. Rapid discontinuation of corticosteroids can result in rebound dermatitis. Patch testing should be performed if treatment fails and the specific allergen or diagnosis remains un-known.

Conclusion:ACD is common and can be a physically, psychologically, and economically burden-some disease. Diagnosis of ACD is primarily based on history (exposure to an allergen) and physi-cal examination (morphology and location of the eruption). Skin patch test can help determine the causative allergen. Allergen avoidance is the cornerstone of management. Topical mid- or high-potency corticosteroids are the mainstay of treatment for lesions on less than 20% of the body area. Severe cases of ACD may require treatment with systemic corticosteroids.