Authors (including presenting author) :
Chan YH, Leung MW, Chan WY, Wu SH, Ma PK, Poon YY, Cheng CH, Lam YY, Luk CK, Chiu WK
Affiliation :
Department of Paediatrics & Adolescent Medicine, United Christian Hospital, Kowloon East Cluster (KEC)
Introduction :
Atopic dermatitis (AD) is the most common paediatric and adolescent cutaneous disease. The population based International Study of Asthma and Allergies in Childhood (ISAAC) revealed that about 15% of children had atopic dermatitis in Hong Kong. Many children and adolescents with widespread AD have superimposed allergic contact dermatitis (ACD). Skin patch test(SPT) is the gold standard to diagnose allergic contact dermatitis. Therefore, the SPT service was introduced in the Department of Paediatric & Adolescent in United Christian Hospital in 2016. This is the first and unique allergy service dedicated to paediatric and adolescent patients in Hong Kong public hospitals and institutions.
Objectives :
To assess the effectiveness of Skin Patch test in enhancing the care of AD patient to find out whether the skin condition is caused by or aggravated by underlying ACD.
Methodology :
Since 2018, twenty-seven Chinese paediatric patients suffering from AD were recruited to join the service. Patient information leaflets on the indications, procedures and nursing care were given prior to commencing the SPT. Patients were assessed to make sure that their eczema was stable and there was no recent use of topical or oral steroid.
Patch tests with 30 substances using the standard “European Standard Series” were tested and applied on the back of patients. The panels were put on the skin for two days, after which they were removed and the skin reactions were measured and interpreted on day 5 by trained medical officers. Results were recorded, analyzed and interpreted.
Result & Outcome :
Twenty-seven Chinese Paediatric patients with AD received skin patch test. Patients ranged from 6 to 18 years of age with 9 females (33.3%) and 18 males (66.7%). Positive reactions were seen in 70.3% of patients, while 33.3% of patients had one or more positive reactions. Fragrance Mix (29.6%), Cobalt (18.5%), Nickle (14.8%) and Textile Dye Mix (14.8%) were the most common allergens.
Nowadays, children and adolescents frequently use cosmetics and accessories that can be the potential sources of allergen. In our 27 patients, 70.3% of them had a positive patch test to at least one allergen. This is important when considering as preventive measures and in the management of intractable AD. Nurses can play an important role in many steps of patch test, which can improve the outcome for patients with intractable dermatitis.
