Contact Dermatitis (Pediatric)

Definition

Contact dermatitis in children is an inflammatory skin condition caused by direct contact with irritants or allergens, leading to redness, itching, and sometimes blistering or oozing.

Epidemiology

• Affects approximately 15–20% of children at some point in childhood
• More common in children with atopic dermatitis or other allergic conditions
• Incidence peaks in toddlers and school-age children
• Both boys and girls are equally affected
• Environmental and household exposures contribute significantly

Etiology

• Irritant contact dermatitis: soaps, detergents, shampoos, acids, or friction
• Allergic contact dermatitis: nickel, fragrances, preservatives, latex, plants (e.g., poison ivy)
• Occupational or hobby-related exposures in older children (paints, adhesives, glues)
• Personal care products and clothing materials
• Atopic predisposition increases susceptibility

Pathophysiology

• Irritant contact dermatitis: direct cytotoxic effect on skin cells causing inflammation
• Allergic contact dermatitis: delayed-type (Type IV) hypersensitivity reaction mediated by T cells
• Activation of skin immune cells leads to release of inflammatory cytokines
• Epidermal barrier disruption facilitates penetration of irritants/allergens
• Chronic scratching worsens barrier dysfunction and inflammation
• Secondary infection may occur due to skin breakdown