As both allergic contact dermatitis and atopic dermatitis have similar clinical presentations and are characterized by spongiotic dermatitis on skin biopsy, many children with AD are not referred for patch testing and allergic contact dermatitis may be underdiagnosed.

Children with atopic dermatitis may also need to be tested for allergic contact dermatitis, according to a new study in the Journal of the American Academy of Dermatology. 

Researchers conducted a retrospective case-control study using the Pediatric Allergic Contact Dermatitis Registry from 2018 to 2022. Of 912 children (615 with AD and 297 without AD), children with AD were more likely to have a longer history of dermatitis, have seen more providers, have greater than one positive patch test (PPT) result, have a greater number of PPT results overall, and have a more generalized distribution of dermatitis.  PPT to bacitracin , carba mix, and cocamidopropyl betaine were significantly increased in children with AD compared to those without AD, the study showed.

“Children with AD are significantly more likely to have PPT reactions and should be referred for evaluation of allergic contact dermatitis and obtain patch testing,” study authors conclude.