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

Allergic contact dermatitis (ACD) is increasingly common in children, with age-related variations suggesting changing exposure patterns. Updating clinical and epidemiological characteristics, sensitization frequency, and relevance of positive patch tests in pediatric patients. 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. 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. 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.