Contact Dermatitis in Children

Contact dermatitis (CD) is a common skin condition that can also affect children. It occurs when the skin comes into direct contact with an irritant or an allergen, leading to an inflammatory reaction. The condition is characterized by redness, itching, and sometimes swelling or blistering of the affected area.It is estimated that 80% of contact dermatitis is Irritant Contact Cermatitis (ICD) and 20% of contact dermatitis is Allergic Contact (ACD). ICD develops because of a direct insult to the stratum corneum, causing alteration in pH or cellular lipids, leading to cell activation and a visible inflammatory reaction. The most common form of ICD in early infancy is diaper dermatitis or napkin dermatitis. ACD is an inflammatory skin disease which affects adults and children worldwide. ACD is an induced IV delayed-type hypersensitivity to a specific antigen, which occurs when a person’s skin surface comes in contact with it, resulting in an allergic reaction. Diagnosis of ACD comes from the combination of clinical data and patch testing. The distribution of dermatitis is of diagnostic importance, but its polymorphic morphology doesn’t usually help with the differential diagnosis among different allergens and between various types of CD. The association between AD and ACD has been studied and still presents controversial results: particularly, the relationship of atopic eczema to the predisposition of ACD has prompted much debate. AD children with ACD for more than one allergen and statistically more girls than boys. A significant difference in contact allergy frequency was demonstrated for those with hand or foot eczema compared to those without: for this reason, AD patients should always be patch tested to evaluate whether they have a relevant contact allergy and thus ACD. Differential diagnosis needs to consider in primis AD, seborrheic dermatitis, psoriasis, infections and infestations. The greater contact with an increasing number of environmental chemicals from jewelry, cosmetics, and personal hygiene products, to sporting gear and toys, made an increment in sensitization in pediatric population, which may be still on rise. They develop the condition from the usual offenders and even from exposure to diapers, baby wipes, sunscreens, clothing with snaps, dyes, etc. Acknowledge of a prevalence increase of this disease, have supported studies worldwide, to push on the patch test technique even at young age, for a quick diagnosis and a better treatment and prevention.