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Patch testing children with aluminium chloride hexahydrate in petrolatum: a review and a recommendation.

Journal article
Authors Elisabet Bergfors
Annica Inerot
Lars Falk
Ulla Nyström
Birger Trollfors
Published in Contact dermatitis
Volume 81
Issue 2
Pages 81-88
ISSN 1600-0536
Publication year 2019
Published at Institute of Clinical Sciences, Department of Dermatology and Venereology
Institute of Medicine, School of Public Health and Community Medicine
Institute of Clinical Sciences, Department of Pediatrics
Pages 81-88
Language en
Subject categories Dermatology and Venereal Diseases


According to studies on adults, patch testing with aluminium chloride hexahydrate 2% pet. is insufficient to detect aluminium allergy and a 10% preparation is recommended. Other studies suggest that a 2% preparation is sufficient for testing children.To review three Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet. published earlier.Altogether 601 children with persistent itching subcutaneous nodules (granulomas) induced by aluminium-adsorbed vaccines were patch tested with aluminium chloride hexahydrate 2% pet. and metallic aluminium in (A) a pertussis vaccine trial, (B) clinical practice and (C) a prospective study.Overall, 459 children had positive reactions to the 2% pet. preparation. Another 10 reacted positively only to metallic aluminium. An extreme positive reaction (+++) was seen in 65% of children aged 1-2 years compared to a share of 22% at 7 years. From 8 years extreme positive reactions were scarce.Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children risk extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely before 7-8 years. This article is protected by copyright. All rights reserved.

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