The burden of children suffering from chronic severe dermatitis and especially from undiagnosed confounding allergic contact dermatitis can be overwhelming for not only the patients and their families but also for their dermatologists. We report our protocol for pediatric patch testing and three pediatric cases, with severe and recalcitrant dermatitis unresponsive to systemic therapies, in whom comprehensive patch testing played a key role in management. Comprehensive patch testing allowed for the culprit allergens to be detected and subsequently avoided. With strict compliance, we were able to cease the use of systemic immunosuppressive therapy. These cases illustrate the importance of patch testing in recalcitrant dermatitis within the pediatric population.