Patch Test Positivity and Allergen Profile in Children with Contact Dermatitis: A Single-Center Study

Background/Objectives: Regional data on contact sensitization in children remain limited and are needed to optimize pediatric patch test series. We aimed to determine the frequency of contact sensitization, identify the most common allergens, and evaluate factors associated with positive patch test results in children with clinically diagnosed contact dermatitis. Methods: We retrospectively reviewed 121 children with clinically diagnosed contact dermatitis who were patch tested with the T.R.U.E. Test to investigate an allergic cause; some also had concomitant atopic dermatitis. Demographic and clinical characteristics, atopic comorbidities, laboratory findings, and patch test results, including reaction intensity, were analyzed. Associations between patch test positivity and clinical variables were assessed using chi-square, Fisher’s exact, and Mann–Whitney U tests. Results: At least one positive reaction was observed in 36 children (29.8%). Nickel sulfate was the most common allergen (8.3%), followed by fragrance mix and gold sodium thiosulfate (5.8% each) and p-phenylenediamine (5.0%). Of 62 positive reactions, 6 were extreme (+++), including three bullous reactions (p-phenylenediamine, n = 2; black rubber mix, n = 1). The positivity rate was lower in children with concomitant atopic dermatitis than in those without (15.8% vs. 36.1%; p = 0.031). No significant associations were found with age, sex, other atopic diseases, family history of atopy, aeroallergen sensitization, total IgE, absolute eosinophil count, or symptom duration. Conclusions: Nearly one-third of children with contact dermatitis showed contact sensitization on patch testing. Markers of atopy were not significantly associated with patch test positivity in this cohort. Allergens outside the European Baseline Series, such as gold, should be considered when designing regional pediatric panels.