Our findings suggest an association between FFA and the use of facial skin care products. The high frequency of sunscreen use in patients with FFA, and the fact that many facial skin care products now contain sunscreens, raises the possibility of a causative role for sunscreen chemicals. The high frequency of positive patch tests in women with FFA and the association with thyroid disease may indicate a predisposition to immune-mediated disease.

This large, multicentre U.K. audit shows a significant rate of allergy to the hydroperoxides of limonene and linalool plus a high rate of irritant reactions. Testing to the oxidized forms alone captures the majority (97·0%; 411 of 422) of positive reactions; testing to nonoxidized terpenes appears to be less useful. We recommend that the hydroperoxides of limonene and linalool be added to an extended baseline patch test series.

General rightsCopyright and moral rights for the publications made accessible in Discovery Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from Discovery Research Portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain.• You may freely distribute the URL identifying the publication in the public portal. Accepted ArticleThis article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/bjd.15648 This article is protected by copyright. All rights reserved. This is the peer reviewed version of the following article: 'Recommendation to test limonene hydroperoxides 0.3% and linalool hydroperoxides 1.0% in the British Baseline patch test series', British Journal of Dermatology, which has been published in final form at http://dx.doi.org/10.1111/bjd.15648. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Accepted ArticleThis article is protected by copyright. All rights reserved. Accepted ArticleThis article is protected by copyright. All rights reserved. ABSTRACT Background:There is a significant rate of sensitisation worldwide to the oxidised fragrance terpenes limonene and linalool. Patch testing to oxidised terpenes is not routinely carried out; the ideal patch test concentration is unknown.

K E Y W O R D S : 2-hydroxyethyl methacrylate, baseline series, patch test Positive reactions, n (%) Relevant positive reactions, n (%) Non-relevant positive reactions, n (%) No. of patients (%) + ++ +++ No. of patients (%) + ++ +++ No. of patients (%) + ++ +++ Total: 61 (1.5)

Eczema is common in the elderly people who often use topical medicaments. Previous studies in the elderly people have noted allergic positive patch tests in between 43% and 64% of those tested. We set out to assess whether medicament contact allergies are more common in elderly patients. We undertook a retrospective age-stratified study of all patients patch tested at the Royal Hallamshire Hospital, Sheffield, between January 1994 and July 2005. We confirmed that contact allergy to topical medicaments is more common in those aged more than 70 years compared with the younger age groups. There was no sex difference. The commonest problematic allergen types found in medicaments were fragrances and preservatives. The most frequent individual allergens were fragrance mix, Myroxylon pereirae, lanolins, local anaesthetic agents, neomycin and gentamicin, and tixocortol pivolate. The pattern of medicament contact allergens was similar to that of the younger age groups except that multiple allergic positives were more frequent and sensitivities to local anaesthetics and Myroxylon pereirae were proportionally more common. Elderly patients were more likely to have multiple contact allergies than the younger ones. Care needs to be taken when prescribing topical medicaments to elderly patients with eczema, especially for preparations that contain perfumes, lanolins, and local anaesthetics.

Over a 10-year period, 230 patients with foot dermatitis were patch tested to a shoe series of allergens. About 54 (23%) had relevant allergic positive reactions to one or more allergens. The commonest relevant allergens groups were, in order, chromate, medicaments, rubber chemicals, dyes and cosmetic constituents, with the most frequent individual allergens being chromate (4%), neomycin (3%), rubber chemicals (> 3%), paraphenylenediamine (2%) and tixocortyl pivolate (2%). Some allergens previously thought to be important, e.g. certain plastic and adhesive chemicals, did not show any positives over the period of study. In addition, para-tertiary butyl phenol formaldehyde resin was a relatively unimportant allergen in this series. The main practical points to emerge from this study are that, in patients with foot dermatitis, chromate is still the principal allergen, and that medicament and cosmetic allergens may be prominent.

We have shown that patch testing can identify relevant allergens in 44% of children with eczema. The commonest relevant allergens were medicament allergens, plant allergens, house dust mite, nickel, Amerchol® L101, and 2-bromo-2-nitropropane-1,3-diol. Patch testing can be performed in children as young as 2 years with the proper preparation.