Fragrance- and Botanical-Related Allergy and Associated Concomitant Reactions: A Retrospective Analysis of the North American Contact Dermatitis Group Data 2007–2016

Atwater, Amber Reck; Ward, Jordan Maxwell; Liu, Beiyu; Green, Cynthia L.; Belsito, D.; Sasseville, Denis; DeKoven, Joel G.; Reeder, Margo J.; Taylor, James S.; Maibach, Howard I.; Silverberg, Jonathan I.; Zug, Kathryn A.; Fowler, Joseph F.; Pratt, Melanie D.; DeLeo, Vincent A.; Warshaw, Erin M.

doi:10.1097/der.0000000000000661

Cited by 15 publications

(22 citation statements)

References 45 publications

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“…Another study from United Kingdom reported even higher sensitization rates (17.2%) that was attributed to the inclusion of oxidized linalool and oxidized limonene to their patch test battery, 16 unlike the present study and the European multicenter study 15 . The North American Contact Dermatitis Group (NACDG), on the other hand, reported a sensitization rate of 22.7% to fragrances among patch-tested patients in the United States and Canada between 2007 and 2016 17 . Botanical allergens were additionally patch tested in their study, but oxidized limonene and linalool were not.…”

Section: Discussioncontrasting

confidence: 65%

“…Colophonium, a well-known cross-reactant of fragrances, was found positive in 2.5% of our patients with fragrance contact allergy. This rate was similar (2.4%) in the NACDG study 17 . It was explained by pseudo–cross-reactivity rather than true cross-reactivity given by the presence of common haptens, such as resin acids, cinnamic compounds, and terpenes, in the fragrance mixes, MP, and colophonium 17 …”

Section: Discussionsupporting

confidence: 57%

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Low Prevalence of Fragrance Contact Allergy Among Turkish Population: A 24-Year, Cross-Sectional, Tertiary Single-Center, Retrospective Study

Özkaya

Sayar

2021

Dermatitis

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Background: Limited data exist on fragrance contact allergy among Turkish population. Objective: The aim of this study was to investigate the frequency and characteristics of fragrance contact allergy in Turkey. Methods: A retrospective cohort study was conducted on 2566 patients consecutively patch tested with the European baseline series and additionally with a fragrance series (n = 358) at a tertiary referral center between 1996 and 2019.Results: One hundred sixty-three patients (6.4%) (male/female, 1.5:1) were sensitized with at least 1 fragrance allergen. Fragrance mix (FM) I was most frequently positive (3.9%), followed by Myroxylon pereirae (3.1%), FM II (2%), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (0.5%), the latter exclusively positive in FM II-positive patients. Among 358 patients patch tested with a fragrance series, positive patch test reactions were observed in 38 patients, including 8 who did not react to baseline fragrance markers. Clinically relevant fragrance allergy was established in 128 patients (78.5%) from nonoccupational (72.4%) and occupational (6.1%) sources.Conclusions: The low prevalence, the middle-aged male preponderance, and the predominant involvement of hands were unusual findings. Rose/citrus-flavored perfumes and eau de cologne, which are traditionally preferred in our country, were important elicitors of fragrance contact allergy, especially among middle-aged and older men.

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionsupporting

confidence: 57%

Low Prevalence of Fragrance Contact Allergy Among Turkish Population: A 24-Year, Cross-Sectional, Tertiary Single-Center, Retrospective Study

Özkaya

Sayar

2021

Dermatitis

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“…12 Our data include final readings at days 4 to 7, but the exact timing of final readings was not recorded in the database. Coreactivity data overlap with a separate analysis of multiple fragrance-related allergens, 30 and some were tested only during certain years.…”

Section: Limitationsmentioning

confidence: 99%

Patch Testing to Carvone: North American Contact Dermatitis Group Experience, 2009 to 2018

et al. 2021

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Background/Objectives: Carvone, a flavoring agent, may cause allergic contact dermatitis. This study summarizes patch test reactions to carvone in patients tested by the North American Contact Dermatitis Group, 2009 to 2018.Methods: This was a retrospective analysis of patients positive to carvone (5% petrolatum). Demographics were compared with those of patients who were negative. Other analyses included reaction strength, clinical relevance, coreactivity with other fragrance/flavor allergens, and exposure sources.Results: Of 24,124 patients tested to carvone, 188 (0.78%) were positive. As compared with carvone-negative patients, carvone-positive patients were significantly more likely older than 40 years (P = 0.0284). Women (76.1%) and/or facial involvement (33.0%) were common in the carvone-positive group but not statistically different from carvone-negative patients; 73.3% (n = 138) of the reactions were currently relevant. Relevant sources were personal care products (46.3%, n = 87) and food (14.3%, n = 27). Coreactivity with other fragrance/flavor markers was present in 60.6% of carvone-positive patients, most commonly fragrance mix I (34.6%), balsam of Peru (24.5%), and cinnamic aldehyde (15.4%).Conclusions: Ten-year prevalence of carvone sensitivity was 0.78%. Most carvone-positive patients were female, were older than 40 years, and/or had facial dermatitis. Personal care products were the most common source. Two-fifths of carvone reactions would have been missed by relying on other fragrance/flavoring allergens.

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“…Several allergens noteworthy for causing doubtful and irritant patch test reactions were associated with high frequency (>40%) of disagreement (defined as any category other than complete or partial disagreement). These included carba mix, 31 oleamidopropyl dimethylamine, 32 iodopropynyl butylcarbamate, 31 cocamidopropyl betaine, 32 methyldibromo glutaronitrile/phenoxyethanol, 33 cinnamic aldehyde, 34 and propylene glycol 35 . All represent “problematic” patch test preparations based on the metrics of positivity ratio (a measure of weak positive reactions) 36 and reaction index (a measure of irritant and doubtful reactions) 37 except cinnamic aldehyde (which is considered “indeterminant”) 38 .…”

Section: Discussionmentioning

confidence: 99%

Inter‐rater variability in patch test readings and final interpretation using store‐forward teledermatology

et al. 2021

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Background Data regarding teledermatology for patch testing are limited. Objectives Compare patch test readings and final interpretation by two in‐person dermatologists (IPDs) with eight teledermatologists (TDs). Methods Patch tested patients had photographs taken of 70 screening series of allergens at 48 hours and second readings. Eight TDs reviewed photos and graded reactions (negative, irritant, doubtful, +, ++, +++) at 48 hours and second readings; in addition, they coded a final interpretation (allergic, indeterminant, irritant, negative) for each reaction. TDs rated overall image quality and confidence level for each patient and patch test reaction, respectively. Percentage of TD–IPD agreement based on clinical significance (success, indeterminate, and failure) was calculated. Primary outcome was agreement at the second reading. Results Data were available for 99, 101, and 66 participants at 48 hours, second reading, and final interpretation, respectively. Pooled failure (+/++/+++ vs negative) at second reading was 13.6% (range 7.9%‐20.4%). Pooled failure at 48 hours and final interpretation was 5.4% (range 2.9%‐6.8%) and 24.6% (range 10.2%‐36.8%), respectively. Confidence in readings was statistically correlated with quality of images and disagreement. Conclusion For patch testing, teledermatology has significant limitations including clinically significant pooled failure percentages of 13.6% for second readings and 24.6% for final interpretation.

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Fragrance- and Botanical-Related Allergy and Associated Concomitant Reactions: A Retrospective Analysis of the North American Contact Dermatitis Group Data 2007–2016

Cited by 15 publications

References 45 publications

Low Prevalence of Fragrance Contact Allergy Among Turkish Population: A 24-Year, Cross-Sectional, Tertiary Single-Center, Retrospective Study

Low Prevalence of Fragrance Contact Allergy Among Turkish Population: A 24-Year, Cross-Sectional, Tertiary Single-Center, Retrospective Study

Patch Testing to Carvone: North American Contact Dermatitis Group Experience, 2009 to 2018

Inter‐rater variability in patch test readings and final interpretation using store‐forward teledermatology

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