This summary discusses pediatric patients. Allergic contact dermatitis in adults is addressed separately.

Contact dermatitis can be due to either allergic or irritant causes. Irritant contact dermatitis is due to nonimmunologic local exposure of the skin to an irritating substance. Allergic contact dermatitis is a cutaneous inflammatory process (type IV cell-mediated or delayed hypersensitivity reaction) usually localized to areas where allergens contact the skin. Beyond the area of primary contact, a secondary dermatitis may develop. Initial sensitization and development of cutaneous inflammation takes 1-4 weeks; however, repeat exposure produces reactions within 48 hours or less.

In children, allergic contact dermatitis is more common after the age of 5 years, but younger children can become sensitized. An estimated 4.4 million children are affected by contact dermatitis in the United States. Allergic contact dermatitis is rare in infants but can be induced as early as the neonatal period.

Diapers, powder, creams, and products used in toileting may instigate contact dermatitis in infants and toddlers. Infants requiring supplemental nutrition via a stoma may develop irritant dermatitis to adhesives. Areas under occlusion or with active erosion are at higher risk for allergen penetration and subsequent allergic contact dermatitis.

Related topic: diaper irritant contact dermatitis