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

Abstract

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.