Pediatric allergic contact dermatitis. Part 2: Patch testing series, procedure, and unique scenarios.

Patch testing is the criterion standard for diagnosing allergic contact dermatitis. Causative allergens differ between children and adults, necessitating the development of pediatric-specific patch test series. The Pediatric Baseline Series was developed in 2018 through expert consensus and includes relevant pediatric allergens that dermatologists can use in practice. Obstacles in patch testing, such as the need for multiple office visits, length of patch application, and avoidance of sweat and water on the testing area, are particularly challenging for the pediatric population, and several strategies are proposed. Aside from formal patch testing, alternatives like the repeat open application test and empiric allergen avoidance can be helpful in children. The key to management of allergic contact dermatitis is allergen avoidance, with emphasis on the need to properly identify causative allergens. Continued data collection through registries allows for a better understanding of the diagnosis and management of pediatric allergic contact dermatitis.

Assessment of the quality of life (QoL) of patients with dermatitis and the impact of patch testing on QoL: A study of 519 patients diagnosed with dermatitis.

BACKGROUND: Dermatitis can impair the quality of life (QoL) of patients. Knowledge of the QoL-associated factors and the impact of patch testing on QoL is limited. OBJECTIVES: To identify demographic and clinical factors affecting QoL, and to measure the impact of patch testing on QoL of dermatitis patients. METHODS: The data and Dermatology Life Quality Index (DLQI) questionnaires of 519 dermatitis patients were analyzed. Of these, 107 underwent patch testing and completed the questionnaires two times (once before testing and again 60 days afterward). RESULTS: The overall mean (±standard deviation) DLQI was 9.5 (±6.4). Patients aged 20 to 59 years and those who had more frequent disease exacerbations demonstrated significantly higher DLQIs. For each DLQI question, being female and aged 20 to 59 years were associated with impairments of various aspects of life, whereas the anatomical site of dermatitis impacted each question differently. The DLQI scores of the patients undergoing patch testing decreased significantly, irrespective of whether the test results were positive or negative. CONCLUSIONS: Being of a working age and having more frequent disease exacerbations had negative QoL impacts. In addition, patch testing improved almost every aspect of the DLQI.

Psychophysiological reactions of patients with atopic dermatitis.

In a laboratory experiment, 20 female patients with atopic dermatitis (AD) and 20 female controls were exposed to two stress situations (watching a film about scarifications and tatooing, mental arithmetic). Recordings were made of systolic blood pressure, diastolic blood pressure, heart rate, skin conductance level (SCL), number of spontaneous (non-specific) electrodermal fluctuations (SF) and the PSI, the number of active palmar sweat glands in an area of the finger pad. Neither in the cardiovascular variables nor the PSI were any significant group differences found, neither for baseline nor stress values, nor for the response reactions. Atopic dermatitis persons had significantly lower values for SCL and SF throughout the whole experiment, although response reactions did not differ between groups. This study lends no support to the assumption of a general psychophysiological overreactivity or individual specific reactions of the skin system in patients with AD.