Contact dermatitis in children

Contact dermatitis is a skin condition characterized by inflammation and irritation resulting from exposure to environmental allergens or irritants. The skin’s barrier function plays a crucial role in protecting against external agents, and disruption of this barrier can lead to the development of contact dermatitis. Allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) are the two primary subtypes, with distinct underlying mechanisms. ACD involves an immune-mediated response to specific allergens, while ICD results from direct damage to the skin. Although previously thought to be less common, contact dermatitis is increasingly being recognized in the pediatric age group. ICD is more common in younger children, while the occurrence of ACD is known to increase with age. Irritants and allergens may differ in the pediatric age group, and newly emerging culprits are being identified every year. This is because of various factors such as urbanization, differences in the variety of toys over the years, the growing number of options available for personal care products, associated diseases like atopic dermatitis, and differences between adult and children’s skin. Even the labeled hypoallergenic products have been found to have a variety of new allergens. It is important to update knowledge regarding various culprits as well as to read labels and test products used by patients, apart from various allergens included in the pediatric patch test series. This highlights the need for ongoing research and updated guidelines. Clinical diagnosis relies on a thorough medical history, physical examination, and patch testing to identify the culprit allergens. Patch testing remains the gold standard for diagnosing ACD, enabling targeted avoidance and treatment. Difficulties of performing patch tests and their interpretation in children are well known. It is also important to establish the relevance of a positive test during a patch test. Management strategies focus on allergen avoidance, skin protection, and topical or systemic therapies to alleviate symptoms and prevent recurrence. Topical corticosteroids and immunomodulators are commonly used treatments, while systemic immunosuppressants may be required for severe cases. This comprehensive review provides an overview of the current understanding of contact dermatitis, its diagnosis, and management. By synthesizing existing knowledge and highlighting recent advances, this article aims to inform healthcare professionals and researchers about the complexities of contact dermatitis and the importance of a multidisciplinary approach to its prevention and treatment.