Allergic contact dermatitis (ACD) in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential
allergens and an immature immune system. Prevalence of ACD to even the most common
allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and
cosmetics in younger patients are potential exposures for sensitization.
Nickel is the most common sensitizer in almost all studies pertaining to pediatric
contact dermatitis. Other common
allergens reported are
cobalt, fragrance mix, rubber,
lanolin, thiomersol,
neomycin,
gold, mercapto mix, balsum of Peru and
colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with
dermatitis that is difficult to control.