This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- Sheila Fallon Friedlander, MD*
- *Assistant Professor, Departments of Pediatrics and Medicine, UCSD School of Medicine; Division of Pediatric Dermatology, Children’s Hospital, San Diego, CA.
Some physicians believe that contact dermatitis is a rather esoteric topic with little relevance to the daily practice of general pediatrics. In reality, contact dermatitis is an extremely common occurrence in the pediatric age group. Some authors estimate that it accounts for approximately 20% of all dermatitis seen in childhood. Although many forms, such as Rhus dermatitis (poison ivy/oak) and diaper dermatitis, are easily recognized and treated, even “diaper rash” occasionally can present a therapeutic challenge and cause significant discomfort to the infant.
Other forms of contact dermatitis may be more difficult to diagnose. A photocontact reaction from the juice or rind of lemons and limes termed phytophotodermatitis causes an eruption that often is misdiagnosed as a burn or occasionally even as child abuse. This can lead to inappropriate and costly evaluations. Of greater concern, contact reactions sometimes can lead to life-threatening situations. Latex, a product of the rubber tree, can cause reactions ranging from mild contact dermatitis to anaphylaxis. Children who have spina bifida or congenital urologic anomalies are at increased risk for this allergy because of increased exposure to latex in catheters or gloves. Therefore, primary care clinicians must be familiar with the basic concepts relating to contact dermatitis. Reasonable queries that might arise, which are addressed in the following discussion, include:
What are the common causes of contact dermatitis in childhood and adolescence?
How should I approach diagnosis and treatment in mild cases?
What other disorders should be ruled out in severe or refractory cases?
How aggressively can I use steroids before referring a patient?
Is patch testing ever useful in childhood?
Epidemiology
The exact incidence of contact dermatitis is unknown. However, two studies evaluating healthy children showed a 20% incidence of positive reactions to one or more patch tests. Almost 50% of infants develop diaper dermatitis, most …
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
