contact%20dermatitis%20(pediatric)
CONTACT DERMATITIS (PEDIATRIC)
Allergic contact dermatitis is an immunologic cell-mediated skin reaction to exposure to antigenic substances.
The lesions initially appear on the cutaneous site of principal exposure then may spread to other more distant sites due to contact or autosensitization. Lesions are typically asymmetrical and unilateral.
Specific signs and symptoms will depend on the duration, location, degree of sensitivity and concentration of allergens. The patch test shows reaction to allergen.
Irritant contact dermatitis is a non-immunologic skin reaction to skin irritants.
It is often localized to areas of thin skin eg eyelids, intertriginous areas.

Contact%20dermatitis%20(pediatric) Signs and Symptoms

Definition

  • An eczematous eruption due to exposure to an irritating local substance (irritant contact dermatitis) or foreign substance causing an allergic response (allergic contact dermatitis)

Etiology

Common Causative Agent
  • Allergic Contact Dermatitis (ACD)
    • Medications, plants, metals (nickel being the most common), foods, fragrances, stabilizers in skin products, chemical sunscreens, preservatives in infant products (eg wet wipes, protective creams, liquid soaps, shampoos), etc
  • Irritant Contact Dermatitis (ICD)
    • Strong alkaline soaps, saliva, citrus juices, bubble bath, sweat, urine and feces (diaper dermatitis), etc
Location of inflammation may suggest trigger factors for ACD and ICD
  • Eg scalp and ears
    • Possible trigger factors: Shampoo, hair dyes, topical medication, spectacles, metal earrings, etc
  • Eg lips, mouth
    • Possible trigger factors: Lip licking/chewing, thumb sucking, excessive drooling, toothpaste, mouthwash
  • Eg face
    • Possible trigger factors: Cosmetics (face make-up, lipstick, nail polish)

Signs and Symptoms

Allergic Contact Dermatitis (ACD)

  • Initially, lesions appear on the cutaneous site of principal exposure; may spread to other more distant sites due to contact or autosensitization
  • Lesions are typically asymmetrical and unilateral
  • Specific signs and symptoms will depend on the duration, location, degree of sensitivity and concentration of allergens
  • A uniformly present feature is pruritus
  • Patch test shows positive reaction to allergen

Acute Allergic Contact Dermatitis (ACD)

  • Acute eruptions present with macular erythema, papules, vesicles and bullae

Subacute Allergic Contact Dermatitis (ACD)

  • Presents with less prominent vesiculations, with scales, crusts, and erythematous patches

Chronic Allergic Contact Dermatitis (ACD)

  • Lesions are usually lichenified, scaling, fissures with or without vesicles
  • Pigmentary changes can occur

Systemic Allergic Contact Dermatitis (ACD)

  • A generalized rash caused by systemic administration of a drug, chemical or food to which the patient has previously been sensitized through topical exposure

Irritant Contact Dermatitis (ICD)

  • May be localized to areas of thin skin (eg eyelids, intertriginous areas) or thick skin (hands, feet) depending on trigger factor

Acute Irritant Contact Dermatitis (ICD)

  • Acute lesions are erythematous and scaly with papules, vesicles, fissures and erosions

Chronic Irritant Contact Dermatitis (ICD)

  • Chronic lesions are dry, erythematous, cracked and lichenified
  • Hardening and adaptation of the skin may occur due to repeated contact with irritants
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
20 Jun 2020
The Lundbeck Neuroscience Symposium was held at Sofitel KL Damansara over 2 days, with extensivediscussions on the management of various mental illnesses. The second day of the symposiumaddressed the topic of schizophrenia management, focusing on treatment goals, the rationale forpartial dopamine D(2) receptor agonism and the use of long-acting injectable (LAI) antipsychotics topromote adherence.
Pearl Toh, 5 days ago
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
4 days ago
Patients with psoriatic arthritis (PsA) often suffer from liver abnormalities, which are associated with higher body mass index (BMI), daily consumption of alcohol, more severe disease, and some therapies, according to a recent study.
Christina Lau, 3 days ago

Pembrolizumab in combination with chemotherapy significantly improves progression-free survival (PFS) vs chemotherapy alone in patients with previously untreated, locally recurrent inoperable or metastatic triple-negative breast cancer (TNBC), results of the KEYNOTE-355 study have shown.