The Changing Spectrum of Pediatric Allergic Contact Dermatitis: A Prospective Multicentric Study in Spain.

Background: Allergic contact dermatitis (ACD) is increasingly common in children, with age-related variations suggesting changing exposure patterns. Objective: Updating clinical and epidemiological characteristics, sensitization frequency, and relevance of positive patch tests in pediatric patients. Methods: This prospective multicenter study analyzed data from the Spanish Contact Dermatitis Research Group registry (REIDAC) for patients aged 0-16 years, stratified into 2 groups: 0-5 and 6-16 years. Participants were patch tested with the GEIDAC baseline and extended series from January 2019 to December 2023. Results: Patch tests were performed on 508 children, of whom 179 (35.2%) were sensitized. Among children aged 0-5 years (n = 41), 10 (24.4%) had positive patch tests, with lesions predominantly affecting the face (51.2%), hands (17.0%), and legs (4.9%). Atopic dermatitis (AD) was present in 36.6%, with linalool and limonene hydroperoxides as top sensitizers. In the 6-16 years group (n = 467), 169 patients (36.2%) were sensitized. AD was present in 45.0%, with lesions involving the face (24.0%), hands (23%), and legs (7.0%). Top allergens were linalool hydroperoxide and methylisothiazolinone. Conclusions: High sensitization proportions in both age groups highlight the importance of patch testing. Hydroperoxides of linalool and limonene are emerging as key sensitizers. Age-specific considerations may improve pediatric ACD management.