A pilot study aimed at finding a suitable eugenol concentration for a leave‐on product for use in a repeated open application test

Svedman, Cecilia; Engfeldt, Malin; Api, A.M.; Politano, V. T.; Belsito, D.; Isaksson, Marléne; Bruze, M.

doi:10.1111/j.1600-0536.2011.02041.x

Cited by 17 publications

(19 citation statements)

References 6 publications

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“…Although the ROAT was originally recommended for twice daily application for 7 days, 16 more recent studies have shown that a ROAT testing period longer than 7 days may be necessary to identify sensitized patients with a delayed response. 17,18 In a study evaluating linalool, most reactions occurred in the third week, 17 whereas a study with eugenol found most sensitive patients to react in the fourth week. 18 Corticosteroid testing may also require a longer exposure and observation period because the antiinflammatory properties of steroids result in a tendency to suppress immunologic reactions, even in allergic individuals.…”

Section: Discussionmentioning

confidence: 98%

“…17,18 In a study evaluating linalool, most reactions occurred in the third week, 17 whereas a study with eugenol found most sensitive patients to react in the fourth week. 18 Corticosteroid testing may also require a longer exposure and observation period because the antiinflammatory properties of steroids result in a tendency to suppress immunologic reactions, even in allergic individuals. However, nickel may elicit a reaction within 1 week.…”

Section: Discussionmentioning

confidence: 98%

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Clinical Utilization of Repeated Open Application Test Among American Contact Dermatitis Society Members

et al. 2015

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Clinical Utilization of Repeated Open Application Test Among American Contact Dermatitis Society Members

et al. 2015

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“…When various usage tests including ROATs have been performed with fragrance sensitizers, positive reactions have been obtained in 0–100% of participants . Major reasons for the great variation are the concentration, the actual dose per cm 2 of the applied usage or ROAT preparation, and the length of the application period.…”

Section: Discussionmentioning

confidence: 99%

“…When various usage tests including ROATs have been performed with fragrance sensitizers, positive reactions have been obtained in 0-100% of participants. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Major reasons for the great variation are the concentration, the actual dose per cm 2 of the applied usage or ROAT preparation, and the length of the application period. In the present study, positive ROAT reactions were obtained in 59% of those hypersensitive to FM I and in 3% of those without contact allergy to FM I.…”

Section: Discussionmentioning

confidence: 99%

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

et al. 2019

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Summary Background In a European study on contact allergy in the general population, it was hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure, and thereafter subsequent avoidance of scented products, implied a diagnosis of allergic contact dermatitis. Objectives The primary aim of this study was to validate this hypothesis and algorithm. The secondary aim was to investigate whether there was any association between the outcome of the repeated open application test (ROAT) and the patch test reactivity. Methods In total, 109 patients with and without contact allergy to fragrance mix (FM) I were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results Positive ROAT reactions were noted in 26 of the 44 volunteers with contact allergy to FM I. None of the volunteers reacted to the vehicle (P < 0·001). More individuals with a positive algorithm had positive ROATs than those with a negative algorithm. However, the difference was not statistically significant. The lower the patch test concentration eliciting a positive test reaction, the more likely a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions The algorithm used in this study was not substantiated in this ROAT set‐up. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period. What's already known about this topic? To the best of our knowledge, a scientifically designed and conducted repeated open application test (ROAT) has never been performed before to validate a diagnosis of allergic contact dermatitis partly based on a questionnaire. What does this study add? This is the largest controlled, randomized and blinded ROAT performed to date. Higher patch test reactivity to fragrance mix I indicated a greater likelihood of a positive ROAT. What are the clinical implications of this work? Further refinement of the questions is required in order to diagnose allergic contact dermatitis from fragrances based on a questionnaire.

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“…Eugenol is found in soaps, antiseptic solutions and emollient creams used by healthcare workers who frequently wash their hands, dentists are exposed to eugenol in mouthwashes, dressings, impression materials and periodontal packings, eugenol is present in 27% of household products, it is commonly included in cutting fluids used by metalworkers and massage therapists are frequently exposed due to the use of essential oils in their trade [ 124 ]. Recently Svedman et al [ 129 ] evaluated the potential of eugenol to cause allergic contact dermatitis in a repeat open application test (ROAT) for a leave-on product. Five volunteers previously sensitised to eugenol were included in the ROAT study where the maximum allowed concentration of eugenol was applied for 4 weeks.…”

Section: Toxicity and Allergenicity Of Eugenolmentioning

confidence: 99%

Eugenol—From the Remote Maluku Islands to the International Market Place: A Review of a Remarkable and Versatile Molecule

2012

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Eugenol is a major volatile constituent of clove essential oil obtained through hydrodistillation of mainly Eugenia caryophyllata (=Syzygium aromaticum) buds and leaves. It is a remarkably versatile molecule incorporated as a functional ingredient in numerous products and has found application in the pharmaceutical, agricultural, fragrance, flavour, cosmetic and various other industries. Its vast range of pharmacological activities has been well-researched and includes antimicrobial, anti-inflammatory, analgesic, anti-oxidant and anticancer activities, amongst others. In addition, it is widely used in agricultural applications to protect foods from micro-organisms during storage, which might have an effect on human health, and as a pesticide and fumigant. As a functional ingredient, it is included in many dental preparations and it has also been shown to enhance skin permeation of various drugs. Eugenol is considered safe as a food additive but due to the wide range of different applications, extensive use and availability of clove oil, it is pertinent to discuss the general toxicity with special reference to contact dermatitis. This review summarises the pharmacological, agricultural and other applications of eugenol with specific emphasis on mechanism of action as well as toxicity data.

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A pilot study aimed at finding a suitable eugenol concentration for a leave‐on product for use in a repeated open application test

Abstract: In patients sensitized to eugenol, with the maximum allowed concentration of eugenol and given a prolonged ROAT (4 weeks), there is a clear risk of elicitating an allergic contact dermatitis.

Cited by 17 publications

References 6 publications

Clinical Utilization of Repeated Open Application Test Among American Contact Dermatitis Society Members

Clinical Utilization of Repeated Open Application Test Among American Contact Dermatitis Society Members

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

Eugenol—From the Remote Maluku Islands to the International Market Place: A Review of a Remarkable and Versatile Molecule

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