Perfume dermatitis. a study of 20 patients

Larsen, Walter G.

doi:10.1001/archderm.113.5.623

Cited by 81 publications

(45 citation statements)

References 3 publications

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“…However, the detection of fragrance sensitization by mixes means that no direct cause-effect relationship is established between the use of perfumed products, their content of different fragrance materials and allergic contact dermatitis. The fragrance mix, or perfume mix, was introduced as a screening tool for fragrance sensitivity in the late 70s following the important work of Larsen (28,86). It contains 8 fragrance materials: eugenol, isoeugenol, oak moss, geraniol, hydroxycitronellal, a-amylcinnamic aldehyde, cinnamic aldehyde and cinnamic alcohol.…”

Section: Detecting Allergic Contact Dermatitis From Fragrances With Tmentioning

confidence: 99%

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Adverse reactions to fragrances

Groot¹,

1997

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Con/act Dermatilis. /997. 36, This article reviews side-effects of fragrance materials present in cosmetics with emphasis on clinical aspects: epidemiology, types of adverse reactions, clinical picture, diagnostic procedures, and the sensitizers. Considering the ubiquitous occurrence of fragrance materials, the risk of sideeffects is small. In absolute numbers, however, fragrance allergy is common, affecting approximately 1% of the general population. Although a detailed profile of patients sensitized to fragrances needs to be elucidated, common features of contact allergy are: axillary dermatitis, dermatitis of the face (including the eyelids) and neck, well-circumscribed patches in areas of "dabbing-on" perfumes (wrists, behind the ears) and (aggravation of) hand eczema. Depending on the degree of sensitivity, the severity of dermatitis may range from mild to severe with dissemination and even erythroderma. Airborne or "connubial" contact dermatitis should always be suspected. Other less frequent adverse reactions to fragrances are photocontact dermatitis, immediate contact reactions and pigmentary changes. The fragrance mix, although very useful for the detection of sensitive patients, both causes false-positive and false-negative reactions, and detects only 70% of perfumeallergic patients. Therefore, future research should be directed at increasing the sensitivity and the specificity of the mix. Relevance is said to be established in 50-65% of positive reactions, but accurate criteria are needed. Suggestions are made for large-scale investigation of several fragrances on the basis of literature data and frequency of use in cosmetics. The literature on adverse reactions to balsam of Peru (an indicator for fragrance sensitivity), essential oils (which currently appear to be used more in aromatherapy than in perfumery) and on fragrances used as flavours and spices in foods and beverages is not discussed in detail, but pertinent side-effects data are tabulated and relevant literature is provided. Key words: perfume; fragrance; adverse reactions; fragrance mix; balsam of Peru; essential oils; allergic contact dermatitis; photosensitivity; immediate contact reactions; pigmented cosmetic dermatitis; occupational contact dermatitis. © Munksgaard, 1997. Accepted for publication 15 October 1996This article reviews side-effects of fragrance materials present in cosmetic products with emphasis on clinical aspects: epidemiology, types of adverse reactions, clinical picture, diagnostic procedures, and the sensitizers. Adverse reactions to balsam of Peru, a marker for fragrance sensitivity (!), which detects approximately 50% of patients allergic to fragrance materials (2), and to fragrances from non-cosmetic sources (e.g., flavours in food) are not discussed in detail. Essential oils seem to be more often used nowadays for medicinal (notably aromatherapy (3)) than for cosmetic purposes. Only the adverse reactions from their presence in cosmetic fragrances are included. However, because of their close relationship to fragr...

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Section: Detecting Allergic Contact Dermatitis From Fragrances With Tmentioning

confidence: 99%

“…Coumarin has occasionally caused positive patch test reactions in patients routinely tested with it, but relevance was not established (86,120 (82).…”

Section: The Fragrance Mix: Very Useful But Not Idealmentioning

confidence: 99%

Adverse reactions to fragrances

Groot¹,

1997

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“…A study [40] showed that 6 out of 20 perfume-sensitive patients reacted to this substance when tested at 5%. However, this report indicated that these 6 patients all reacted to other test materials, most notably hydroxycitronellal.…”

Section: (I) Tests Producing Reactionsmentioning

confidence: 99%

Is There Evidence that Geraniol Causes Allergic Contact Dermatitis?

Hostýnek¹,

Maibach²

2004

Exog Dermatol

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The fragrance material geraniol has been cited as a frequent cause of allergic contact dermatitis. A review of the literature shows that when the underlying clinical and experimental data are analyzed, a clear cause-effect relationship has infrequently or rarely been established. On the basis of the generally weak sensitizing potential of this substance coupled with its generally low exposure conditions, the prevalence of clinical cases would not be expected to be particularly high. This is not to say that geraniol is a frequent inducer of type IV allergy in members of the public. It remains to be seen, however, how often such allergy, once established, is responsible for any of the cases of allergic contact dermatitis commonly ascribed in the literature. Indeed, in some cases, patch-test conditions may not be optimal for differentiating between clinically relevant and irrelevant allergy to geraniol. Because of the numerous publications on geraniol-positive patch-test publications, a future effort to ascertain how many of these represent clinical intolerance is indicated. This will also permit determination of the NOEL (no observed effect level) in patch and use testing.

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“…A study [Larsen, 1977] showed that 4 out of 20 perfume-sensitive patients reacted to this substance when tested at 5%. However, this report indicated that these 4 patients all reacted to other test materials, most notably cinnamic alcohol.…”

Section: Clinical Diagnostic Tests On Patientsmentioning

confidence: 99%

Is There Evidence that Anisyl Alcohol Causes Allergic Contact Dermatitis?

Hostýnek¹,

Maibach²

2003

Exog Dermatol

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The fragrance material anisyl alcohol has been cited as a moderately frequent cause of allergic contact dermatitis. A review of the literature shows that when the underlying clinical and experimental data are analyzed, a clear cause-effect relationship has infrequently or rarely been established. On the basis of the generally weak sensitizing potential of this substance coupled with its generally low exposure conditions, the prevalence of clinical cases would not be expected to be particularly high. This is not to say that anisyl alcohol is a frequent inducer of type IV allergy in members of the public. However, it remains to be seen how often such an allergy, once established, is responsible for any of the cases of allergic contact dermatitis commonly ascribed in the literature. Indeed, in some cases, patch test conditions may not be optimal for differentiating between clinically relevant and irrelevant allergy to anisyl alcohol.

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Perfume dermatitis. a study of 20 patients

Cited by 81 publications

References 3 publications

Adverse reactions to fragrances

Adverse reactions to fragrances

Is There Evidence that Geraniol Causes Allergic Contact Dermatitis?

Is There Evidence that Anisyl Alcohol Causes Allergic Contact Dermatitis?

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