Allergic contact dermatitis (pediatric) in Child
Contact dermatitis can be due to either allergic or irritant causes. Irritant contact dermatitis is due to nonimmunologic local exposure of the skin to an irritating substance. Allergic contact dermatitis is a cutaneous inflammatory process (type IV cell-mediated or delayed hypersensitivity reaction) localized to areas where allergens contact the skin. Initial sensitization and development of cutaneous inflammation takes 1-4 weeks; however, repeat exposure produces reactions within 48 hours.
In children, allergic contact dermatitis is more common after the age of 5, but younger children can become sensitized. The incidence and prevalence of contact dermatitis has increased steadily over the decades; an estimated 4.4 million children are affected in the United States. This figure reflects those presenting for evaluation; many more affected children may remain undiagnosed.
The most common contact allergens in children are cocamidopropyl betaine (CAPB, seen in baby soap / shampoo), nickel, fragrance, compositae mix (parthenolide), cobalt (a metal), lanolin (emollients), colophony (adhesives), methylchloroisothiazolinone / methylisothiazolinone (MCI/MI; preservative in diapers, wipes, liquid soap), chromates (leather products), neomycin, and oxybenzone (sunscreens). Thimerosal is no longer considered a relevant allergen (formerly used in ophthalmic preparations and vaccines). The distribution and geometry of lesions are important clues to diagnosis.
Related topic: training pant
L23.9 – Allergic contact dermatitis, unspecified cause
238575004 – Allergic contact dermatitis
- Tinea pedis – often affects toe webs, and usually asymmetric
- Tinea manuum
- Juvenile plantar dermatosis
- Dyshidrotic dermatitis
- Tinea corporis
- Seborrheic dermatitis – less pruritic, localized to seborrheic areas
- Irritant contact dermatitis – history of irritant exposure, resolves with low- to mid-potency steroids and gentle skin care
- Atopic dermatitis – history of atopy, characteristic location of lesions (flexures, face, and acral extremities)
- Impetigo – flaccid bullae and honey-colored crust, with ill-defined, nongeometric borders
- Facial cellulitis is accompanied by pain, fever, and systemic symptoms.
- Phytophotodermatitis – a phototoxic eruption