An updated understanding of allergic contact dermatitis (ACD) is needed, particularly in children.
To compare positive and clinically-relevant reactions in children vs. adults referred for patch testing.
Retrospective analysis of 1,871 children and 41,699 adults from the North American Contact Dermatitis Group from 2001-2018.
Both final diagnosis of ACD (55.2% vs. 57.3%; Chi-square, P-value: 0.0716) and prevalence of ≥1 currently relevant reaction to a NACDG screening allergen (49.2% vs. 52.2%; P-value: 0.1178) were similar between children and adults. In children, the most commonly currently-relevant allergens were nickel sulfate (17.3%), hydroperoxides of linalool (7.8%), methylisothiazolinone (7.7%), cobalt chloride (7.0%), and fragrance mix I (4.9%). Approximately, one-fifth of children were positive to a non-NACDG allergen.
Over half of children referred for patch testing were diagnosed with ACD. The most common relevant allergens in children were nickel sulfate, cobalt chloride, and hydroperoxides of linalool. Twenty percent of children had at least one positive reaction to allergens/substances not on the NACDG screening series, underscoring the need for comprehensive testing.

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