Pediatric Contact Dermatitis: Common Allergens in Children

Overview / Definition Pediatric contact dermatitis is a form of dermatitis that occurs when the skin comes into direct contact with an allergen or irritant, leading to an inflammatory response. It is classified into two main types: allergic contact dermatitis and irritant contact dermatitis. Allergic contact dermatitis results from a hypersensitivity reaction, while irritant contact dermatitis is caused by direct damage to the skin barrier. Epidemiology Contact dermatitis is common in children, particularly those aged 1 to 4 years. It can occur in both sexes but may be more prevalent in boys due to higher rates of outdoor play and exposure to allergens. The incidence of allergic contact dermatitis in children has increased, likely due to environmental factors and changes in skin care products. Prevalence increases with age Common in children with atopic dermatitis Higher rates in urban populations Pathophysiology / Mechanism The pathophysiology of allergic contact dermatitis involves a two-step process: sensitization and elicitation. During sensitization, an allergen penetrates the skin and is processed by Langerhans cells, leading to activation of T-lymphocytes. Upon re-exposure, these sensitized T-cells mount an immune response, causing inflammation and symptoms. Allergens can include metals, fragrances, preservatives, and plants. Type IV hypersensitivity reaction is the underlying mechanism. Clinical Presentation The presentation of pediatric contact dermatitis varies based on the type and duration of exposure. Symptoms typically include: Redness and swelling of the skin Itching or burning sensation Vesicles or bullae in cases of severe reaction Dry, scaly patches in chronic cases Locations of dermatitis often correlate with the allergen, for example, diaper dermatitis from irritants or nickel dermatitis from jewelry. Diagnosis / Workup Diagnosis is primarily clinical, based on the history and physical examination. A thorough history should include: Onset and dur