Introduction

Allergic contact dermatitis (ACD) is a delayed-type, T-cell-mediated inflammatory skin disease increasingly recognised in children and adolescents. Patch testing identifies contact sensitisation, but paediatric data on exposure-related patterns remain limited.

Aim

This study aimed to evaluate patch test positivity, hapten distribution, clinical relevance, and exposure-related factors in children and adolescents with suspected ACD.

Material and methods

This retrospective single-centre study included patients aged ≤ 18 years who underwent patch testing with a standardised ready-to-use patch test panel between March 2025 and March 2026. Demographic, clinical, laboratory, exposure-related, and patch test data were reviewed/retrieved from medical records.

Results

Of 99 initially identified patients, 82 were included. The median age was 13 years, and 61% were female. Hand/wrist involvement was most common (52.4%). At least one positive patch test reaction was observed in 47 (57.3%) patients, and 36 of these patients (76.6%) had clinically relevant reactions. Overall, 98 positive patch test reactions were recorded, of which 39 (39.8%) were considered currently clinically relevant. Metals represented the most frequent sensitiser group (27.6%), followed by preservatives (26.5%). Nickel sulfate was the most frequently positive individual hapten on patch testing (12/98, 12.2%). Documented exposure history was associated with patch test positivity (OR = 3.89, 95% CI: 1.51–10.03; p = 0.006) and clinically relevant reactions (OR = 15.63, 95% CI: 4.18–58.49; p < 0.001). Occupational/vocational exposure was mainly observed in adolescents and was associated with patch test positivity (p = 0.035).

Conclusions

Patch testing is valuable in selected paediatric patients with suspected ACD. Positive reactions should be interpreted together with hapten-specific exposure and the clinical pattern of dermatitis.