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Are children with atopic dermatitis at greater risk of contact allergy?

Children and eczema: Presentation of recent scientific literature

This is part of the first series of medical report round-ups presenting some of the latest research on dermatology. We’ve pulled together the following information on a recent study on the link between contact allergy and children with atopic dermatitis. Contact allergy, also known as contact dermatitis, is a condition that makes skin red or inflamed after contact with an allergen or an irritant.

  • Children with atopic dermatitis seem to be at greater risk of developing contact allergy to certain metals and components of skincare products. The impaired skin barrier in children with atopic dermatitis (AD) allows potential allergens to more easily penetrate the skin. Metals are the most common allergen among children with AD.  
  • Children with atopic dermatitis may have unacknowledged contact allergies contributing to their skin symptoms. Diagnosing contact allergy to, for instance, corticosteroids can be a major challenge, however, it is very important to do so to eliminate the risk of undiagnosed contact allergies worsening the symptoms of atopic dermatitis..The possibility of a contact allergy to topical treatments should not be ignored in the evaluation of a child with eczema that does not respond to treatment.
  • Caregivers should use unscented products with as few components as possible and preservatives with a low potential to aggravate the skin. Children with AD are exposed to topical agents including corticosteroids and emollients from an early age, and the prolonged use of these agents could increase the risk of contact allergy to the ingredients. As emollients are a part of the basic treatment of AD, it is important that caregivers are aware of what products they use for their children to avoid the risk of worsening symptoms by applying products that are likely to aggravate the skin.

The above mentioned conclusions are based on a recent study across 21 clinical studies. However, whether children with AD have an altered risk of contact allergy compared with children without AD remains a bit controversial and the studies are a bit conflicting. Theoretically, the impaired skin barrier in AD facilitates the penetration of potential allergens. Several authors have highlighted the risk of underestimating and overlooking atopic contact dermatitis (ACD).

Reference

Title of publication: Contact allergy in children with atopic dermatitis: a systematic review

Date and journal: British journal of dermatology, 21st April 2017

Link to article: Br J Dermatol. 2017 Aug;177(2):395-405. doi: 10.1111/bjd.15628. Epub 2017 Jun 12.

 

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