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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.
Scleromyxoedema is a rare disease characterized by a generalized papular and sclerodermoid cutaneous eruption. It is associated with fibroblast proliferation and mucin deposition in the dermis. Most patients have a monoclonal gammopathy, defined by the presence of IgG. Treatment of scleromyxoedema is challenging, but there is mounting evidence to support the use of intravenous immunoglobulin (IVIg). Individual reports of systemic complications have been described. Dermatoneuro syndrome (DNS) is a rare but sometimes fatal manifestation, which consists of a triad of fever, coma and seizures preceded by a flu-like illness. We describe a patient with scleromyxoedema who developed DNS. Our case highlights interesting findings suggesting that DNS may have a viral aetiology. In addition, this case demonstrates a favourable response of the cutaneous features of scleromyxoedema to IVIg.
Within the range of testing intensities covered by our reporting centres, the data show that as the intensity of testing increases, the rate of patients with positive reactions decreases.
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