Fragrance contact dermatitis: A worldwide multicenter investigation (Part I)

Larsen, Walter G.; Nakayama, Hideo; Lindberg, Magnus; Fischer, Torkel; Elsner, Peter; Burrows, D.; Jordan, William P.; Shaw, S.; Wilkinson, J. D.; Marks, James G.; Sugawara, Makoto; Nethercott, James R.

doi:10.1016/s1046-199x(96)90078-0

Cited by 138 publications

(42 citation statements)

References 18 publications

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“…The FM PT-positive rate was 15.9% in our study. Previous studies showed that the prevalence of FM reactions in PT clinics worldwide was high and often ranked among the top 3 allergens (11). In dermatitis patients evaluated by patch testing, reactions to FM have ranged from 5.9% in Slovenia to 19.5% in Hong Kong (3,4).…”

Section: Discussionmentioning

confidence: 99%

A clinical and patch test study of patients with positive patch test reactions to fragrance mix in China

Wang

et al. 2005

Contact Dermatitis

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The clinical and patch test (PT) features of patients with positive PT reactions to fragrance mix (FM) were studied. 378 consecutive eczema outpatients patch tested with a modified European standard series were analysed. 60 patients (15.9%) reacted to FM. No significant differences could be found between the ages of FM PT-positive and PT-negative patients [median age 40.5 (range from 18 years to 69 years) versus median age 37.5 (range from 5 years to 81 years), rank sum test, P = 0.301]. FM PT-positive rate in confirmed non-cosmetic allergic contact dermatitis patients was 30.4%, which was similar to that in confirmed cosmetic allergic contact dermatitis patients (30.4% versus 30%, chi(2) test, chi(2) = 0.0010, P = 0.972). The FM PT-positive rates were 10.8% in males and 18.2% in females (chi(2) test, chi(2) = 3.3443, P = 0.067). 76.7% of the patients with fragrance contact dermatitis were allergic to Chinese traditional medicine, which is much higher than that for cosmetic allergy (76.7% versus 43.3%, chi(2) test, chi(2) = 6.9446, P = 0.008). The positive PT rate to colophonium in the patients with positive PT reactions to FM is higher than that in the FM PT-negative patients (18.9% versus 3.0%, chi(2) test, chi(2) = 15.5471, P < 0.01). 62.5% of the patients reacted to colophonium were positive to FM. These results show that age has little effect on fragrance contact allergy. Other fragrant products besides cosmetics are also important sources of fragrance contact allergy. Chinese traditional medicine was an important factor in fragrance allergy in China. Patients with positive PT reactions to FM are more likely to react to colophonium.

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Section: Discussionmentioning

confidence: 99%

A clinical and patch test study of patients with positive patch test reactions to fragrance mix in China

Wang

et al. 2005

Contact Dermatitis

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“…Coumarin, an ingredient in cosmetics and fragrances, was chosen as the reference chemical, since there is a controversy as to whether coumarin is a contact allergen involved in fragrance allergy. Indeed, coumarin allergy, defined by positive skin patch tests, was observed in up to 6.8% of patients with ACD [9,10,11,12,13]. Moreover, it was shown that coumarin was endowed with irritant properties at the concentration of 8% [13].…”

Section: Introductionmentioning

confidence: 99%

The Skin Allergenic Properties of Chemicals May Depend on Contaminants – Evidence from Studies on Coumarin

Vocanson

Goujon

Chabeau

et al. 2006

Int Arch Allergy Immunol

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Background/Aims: Positive patch tests are considered representative of a contact allergy to the tested chemical. However, contaminants and derivatives rather than the suspected chemical itself could be responsible for the allergic skin reactions. Here, we tested the importance of contaminants in the sensitizing and allergenic properties of coumarin in mice and humans. Coumarin, an ingredient in cosmetics and fragrances, was chosen as the reference chemical since conflicting results have been obtained regarding its ability to induce contact allergy. In some chemical preparations, this could be explained by the presence of coumarin derivatives endowed with allergenic properties. Methods: In mice, three different coumarin preparations were tested in the local lymph node assay. In humans, we assessed the irritant and allergenic properties of highly pure coumarin in nonallergic and fragrance-allergic patients. Results: Pure coumarin did not exhibit irritant or sensitizing properties in the local lymph node assay. In contrast, two other commercially available coumarins and three contaminants that were detected in these coumarin preparations were identified as weak and moderate sensitizers, respectively. In humans, pure coumarin was extremely well tolerated since only 1 out of 512 patients exhibited a positive patch test to the chemical. Conclusions: These results indicate that coumarin cannot be considered as a common contact allergen and further emphasize that purity of chemicals is mandatory for the assessment of their allergenicity.

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“…The prevalence of fragrance mix (FM) reactions in patch test clinics worldwide is high and often ranks among the top 3 allergens [3]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence of Fragrance Allergy

Scheinman¹

2002

Dermatology

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With the exception of the UK, where fragrance allergy remained fairly constant from the early 1980s until the mid-late 1990s, other centers worldwide (Denmark, Singapore, Slovenia and the USA) reported an increase in fragrance allergy during this period. The ubiquitous nature of fragrance in modern society, coupled with new and growing markets of fragrance products for children and men, likely contribute to this increase. Strict adherence to voluntary guidelines on concentration limits of known fragrance sensitizers in consumer products is necessary. Also, special attention by manufacturers to safety assessments for fragranced products to be used on ‘high-risk’ areas such as traumatized/dermatitic skin, occluded sites and areas of high absorption is needed.

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Fragrance contact dermatitis: A worldwide multicenter investigation (Part I)

Cited by 138 publications

References 18 publications

A clinical and patch test study of patients with positive patch test reactions to fragrance mix in China

A clinical and patch test study of patients with positive patch test reactions to fragrance mix in China

The Skin Allergenic Properties of Chemicals May Depend on Contaminants – Evidence from Studies on Coumarin

Prevalence of Fragrance Allergy

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