Pediatric Annals

CME Article 

Contact Dermatitis: From Basics to Allergodromes

Rajiv I. Nijhawan, BS; Catalina Matiz, MD; Sharon E. Jacob, MD

Abstract

Parents frequently bring their infants, toddlers, children and adolescents to see their pediatricians for various dermatologic concerns. Primary care providers are the pivotal physicians who determine which patients can be managed in their offices and which patients need a referral to the dermatologist. Unfortunately, the burden of dermatitis can be overwhelming for all involved including the patient, family, pediatrician, and dermatologist. Although some dermatologic conditions (eg, atopic eczema) are more easily diagnosed, allergic contact dermatitis (ACD) is commonly under-recognized and overlooked, especially if it is a contributing factor to worsening atopic dermatitis (AD). Segurado Rodriguez et al linked ACD to a family history of AD (85%), female sex (74%), and 11 to 16 years (63%).

ABOUT THE AUTHORS

Rajiv I. Nijhawan, BS, is 4th year medical student, Department of Dermatology and Cutaneous Surgery University of Miami-Miller School of Medicine. Catalina Matiz, MD, is Pediatric and Adolescent Research Fellow, Department of Pediatrics and Adolescent Dermatology, University of California-San Diego, Rady Children’s Hospital, San Diego. Sharon E. Jacob, MD, is Assistant Professor of Medicine and Pediatrics (Dermatology), Departments of Medicine and Pediatrics (Dermatology) University of California-San Diego, Rady Children’s Hospital.

Address correspondence to Sharon E. Jacob, MD, Assistant Professor, Departments of Medicine and Pediatrics (Dermatology), University of California-San Diego, Rady Children’s Hospital, 8010 Frost Street, Suite 602, San Diego, CA 92123; fax: 858-966-7476; e-mail: sjacob@contactderm.net.

Mr. Nijhawan, Dr. Matiz, and Dr. Jacob have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Outline the clinical presentations and pathophysiology of both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD).
  2. Review the most common allergens and products responsible for allergic contact dermatitis in children.
  3. Discuss the recommendations for management of children with suspected contact dermatitis including guidelines for referral for patch testing.

Abstract

Parents frequently bring their infants, toddlers, children and adolescents to see their pediatricians for various dermatologic concerns. Primary care providers are the pivotal physicians who determine which patients can be managed in their offices and which patients need a referral to the dermatologist. Unfortunately, the burden of dermatitis can be overwhelming for all involved including the patient, family, pediatrician, and dermatologist. Although some dermatologic conditions (eg, atopic eczema) are more easily diagnosed, allergic contact dermatitis (ACD) is commonly under-recognized and overlooked, especially if it is a contributing factor to worsening atopic dermatitis (AD). Segurado Rodriguez et al linked ACD to a family history of AD (85%), female sex (74%), and 11 to 16 years (63%).

ABOUT THE AUTHORS

Rajiv I. Nijhawan, BS, is 4th year medical student, Department of Dermatology and Cutaneous Surgery University of Miami-Miller School of Medicine. Catalina Matiz, MD, is Pediatric and Adolescent Research Fellow, Department of Pediatrics and Adolescent Dermatology, University of California-San Diego, Rady Children’s Hospital, San Diego. Sharon E. Jacob, MD, is Assistant Professor of Medicine and Pediatrics (Dermatology), Departments of Medicine and Pediatrics (Dermatology) University of California-San Diego, Rady Children’s Hospital.

Address correspondence to Sharon E. Jacob, MD, Assistant Professor, Departments of Medicine and Pediatrics (Dermatology), University of California-San Diego, Rady Children’s Hospital, 8010 Frost Street, Suite 602, San Diego, CA 92123; fax: 858-966-7476; e-mail: sjacob@contactderm.net.

Mr. Nijhawan, Dr. Matiz, and Dr. Jacob have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Outline the clinical presentations and pathophysiology of both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD).
  2. Review the most common allergens and products responsible for allergic contact dermatitis in children.
  3. Discuss the recommendations for management of children with suspected contact dermatitis including guidelines for referral for patch testing.

Parents frequently bring their infants, toddlers, children and adolescents to see their pediatricians for various dermatologic concerns. Primary care providers are the pivotal physicians who determine which patients can be managed in their offices and which patients need a referral to the dermatologist. Unfortunately, the burden of dermatitis can be overwhelming for all involved including the patient, family, pediatrician, and dermatologist. Although some dermatologic conditions (eg, atopic eczema) are more easily diagnosed, allergic contact dermatitis (ACD) is commonly under-recognized and overlooked, especially if it is a contributing factor to worsening atopic dermatitis (AD). Segurado Rodriguez et al linked ACD to a family history of AD (85%), female sex (74%), and 11 to 16 years (63%).

ABOUT THE AUTHORS

Rajiv I. Nijhawan, BS, is 4th year medical student, Department of Dermatology and Cutaneous Surgery University of Miami-Miller School of Medicine. Catalina Matiz, MD, is Pediatric and Adolescent Research Fellow, Department of Pediatrics and Adolescent Dermatology, University of California-San Diego, Rady Children’s Hospital, San Diego. Sharon E. Jacob, MD, is Assistant Professor of Medicine and Pediatrics (Dermatology), Departments of Medicine and Pediatrics (Dermatology) University of California-San Diego, Rady Children’s Hospital.

Address correspondence to Sharon E. Jacob, MD, Assistant Professor, Departments of Medicine and Pediatrics (Dermatology), University of California-San Diego, Rady Children’s Hospital, 8010 Frost Street, Suite 602, San Diego, CA 92123; fax: 858-966-7476; e-mail: sjacob@contactderm.net.

Mr. Nijhawan, Dr. Matiz, and Dr. Jacob have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Outline the clinical presentations and pathophysiology of both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD).
  2. Review the most common allergens and products responsible for allergic contact dermatitis in children.
  3. Discuss the recommendations for management of children with suspected contact dermatitis including guidelines for referral for patch testing.

10.3928/00904481-20090201-07

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