Frequent Positive Patch Test Reactions to Glucosides in Children: A Call for Caution?

BACKGROUND

Alkyl glucosides are surfactants commonly found in cosmetics and household products. However, data on glucoside contact allergy in paediatric populations is limited.

OBJECTIVES

To determine the prevalence, relevance and clinical characteristics of contact allergy to glucosides in children.

METHODS

A retrospective review of the files of paediatric patients (≤ 16 years) who underwent patch testing for decyl glucoside (DG) and/or lauryl glucoside (LG) at the Antwerp University Hospital (UZA) in the period between January 2018 and December 2024.

RESULTS

Among 241 children tested for DG, 148 (61.4%) were also tested for LG. DG reactions were observed in 47 patients (19.5%), with 27 (11.2%) considered positive. LG reactions occurred in 17/148 (13%), but only 4 (2.7%) were positive, all with concomitant DG reactions. Most positive DG reactions were weak (+) (25/27), whereas only 2 were strong (++). The median age was 7 years (range: 2-15), with 51.9% female. Culprit sources mostly included cosmetics.

CONCLUSIONS

Patch test reactions to glucosides readily occur in children, and the positivity rate is surprisingly high. Besides many irritant and doubtful reactions, false-positive (+) reactions likely occur, particularly in young atopic children. Careful interpretation of positive results and complementary work-up may thus be necessary.