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Patch Testing Children With Aluminium Chloride Hexahydrate in Petrolatum: A Review and a Recommendation

Patch Testing Children With Aluminium Chloride Hexahydrate in Petrolatum: A Review and a Recommendation

Elisabet Bergfors, Annica Inerot, Lars Falk, Ulla Nyström, Birger Trollfors

Contact Dermatitis. 2019 Aug;81(2):81-88.

PMID: 31066081

Abstract:

Background:
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.
Objectives:
To review three previously published Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet.
Patients/methods:
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.
Results:
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 to 2 years as compared with 22% of children aged 7 years. From 8 years onwards, extreme positive reactions were scarce.
Conclusions:
Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children are at risk of extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely in children before the age of 7 to 8 years.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
CS35328	Nabam-d4 hexahydrate			Price

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