Patch Test Series for Allergic Perineal Dermatitis in the Diapered Infant

Background: Allergic perineal dermatitis (PD) due to diaper wipes, topical medicaments, or diapers has been reported. Although patch testing is the criterion standard for detection of allergic contact dermatitis in children, this is limited by body surface area, decreased tolerance of the patch testing procedure, and increased false-positive rates due to irritant reactions. Therefore, a targeted patch testing series is necessary to better screen diapered infants for possible allergic PD. Objective: We propose 2 patch test series (PD series 1 and 2) to screen infants with possible allergic PD. Methods: Allergens are chosen using existing sensitization data of common allergens in children, published case reports, and the collective experience of American Contact Dermatitis Society members through an electronic survey. Results: PD series 1 includes 23 potential allergens found in wet wipes and topical diaper preparations. PD series 2 contains 10 potential allergens most commonly found in diapers. Conclusions: We believe that these judiciously chosen patch test series will increase the yield of detecting the causes of allergic PD while not exposing children to an unnecessarily large screening patch test panel.

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