The frequency of symptoms of contact eczema among schoolchildren and adolescents in a questionnaire survey carried out in schools of Krakow in 2007-2009

Abstract: Contact eczema (allergic and non-allergic i.e. irritant eczema) has been underdiagnosed in children. In recent years, the number of cases diagnosed with this disease is increasing, which may be attributed to either an increase of the frequency of the disease, or an increased use of diagnostic patch tests. The aim of this study was to analyze the frequency of contact eczema among schoolchildren and adolescents in Krakow. Material and methods: 28 339 pupils from all schools in Krakow participated in the study; they were divided into two age groups: 7 years old (11 530 pupils; 5 527 girls and 6 003 boys), and 16 years old (16 809 pupils; 7 897 girls and 8 912 boys). The research tool was a questionnaire based on ISAAC (International Study of Asthma and Allergies in Childhood), supplemented with a screening part, and a questionnaire concerning the occurrence of symptoms suggestive of contact eczema. Based on the affirmative answers to the ISAAC questions about eczema and the questions in supplementary part concerning contact eczema, the prevalence of eczema in general, eczema according to ISAAC, flexural eczema according to ISAAC, and contact eczema was assessed. Results: The overall frequency of eczema symptoms was assessed at 28.9% of 7 year-olds (y.o.), and 16.9% of 16 y.o. (p<0.001). The rates of eczema recognized exclusively by the ISAAC questionnaire were 23.9 % among 7 y.o., and 12.3% among 16 y.o. (p<0.001), flexural eczema according to ISAAC was detected in 6.4% of 7 y.o. and 3.1% of 16 y.o. (p<0.001), and symptoms of contact eczema were reported by 5.0% of 7 y.o. and 4.6% of 16 y.o. Among study participants with affirmative answers to the ISAAC question about flexural eczema (commonly regarded as characteristic of atopic eczema), 31.3% of 7 y.o. and 42.8% of 16 y.o. reported on symptoms of contact eczema. Conclusions: Symptoms suggestive of contact eczema are present in approximately 5% of the general population of schoolchildren and adolescents. One third of children and a half of adolescents, who fulfill the criteria of flexural eczema according to ISAAC, also have symptoms indicative of contact eczema. Therefore, the presence of flexural eczema detected in ISAAC studies must not be considered as an equivalent for the diagnosis of atopic eczema

Key words: questionnaire, contact eczema, atopic eczema, children.

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