Allergic contact dermatitis (pediatric) in Child
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. As in adults, the most common contact allergens in children are urishiol (poison ivy, oak, or sumac), nickel, fragrance, cobalt (a metal), chromates (leather products), neomycin, thimerosal (ophthalmic preparations and vaccines), adhesives, and oxybenzone (sunscreens). The distribution and geometry of lesions are important clues to diagnosis.
Per February 2019, isobornyl acrylate was named the "contact allergen of the year" by the American Contact Dermatitis Society. It is an acrylic monomer often used as an adhesive in medical devices, and there have been multiple case reports of diabetes patients developing contact allergies to their insulin pumps. Clinician awareness is important, because testing using routine panels does not identify isobornyl acrylate.
Related topics: Irritant contact dermatitis, Hand dermatitis
L23.9 – Allergic contact dermatitis, unspecified cause
40275004 – Contact dermatitis
- Tinea pedis – Often affects toe webs, and usually asymmetric.
- 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, honey-colored crust, with ill-defined, nongeometric borders.
- Facial cellulitis is accompanied by pain, fever, and systemic symptoms.