Contact allergy to fragrance mix I and its components in individuals with photocontact allergy to ketoprofen

Abstract

Background: Contact allergy to fragrance mix I (FM I) is over-represented in patients photoallergic to ketoprofen. The prevalence of contact allergy to two components of FM I, cinnamal and cinnamyl alcohol, in ketoprofen-photoallergic patients is higher than in dermatitis patients.Objective: To explore the prevalence of contact allergy to FM I and its individual components in patients with photocontact allergy to ketoprofen, and to compare with a dermatitis and the general population.Methods: Data on patch and photopatch tests performed between 2009-2018 were collected. Ketoprofen-photoallergic patients were compared with dermatitis patients and published data on the general population regarding the prevalence and the distribution of contact allergy to FM I and its components.Results: A higher prevalence of contact allergy to cinnamyl alcohol compared with cinnamal (23.3% vs 10.0%), and eugenol compared with isoeugenol (23.3% vs 6.7%), was observed in ketoprofen-photoallergic patients, while the relationship was the opposite in the dermatitis group (0.7% vs 1.05%; 0.4% vs 0.9%). The overall prevalence of contact allergy to several components of FM I was significantly higher in ketoprofen-photoallergic patients.Conclusions: Contact allergy to FM I and many of its components is over-represented in patients photoallergic to ketoprofen compared with dermatitis patients and the general population.

Relevant sensitization to diethylamino hydroxybenzoyl hexyl benzoate and fragrances in a patient with frontal fibrosing alopecia and acquired dermal macular hyperpigmentation

“…The positive reactions to diethylamino hydroxybenzoyl hexyl benzoate and to cinnamal and cinnamic alcohol are likely due to concomitant sensitization as all three were present in products used by the patient. Co‐sensitizations to cinnamal and cinnamyl alcohol have recently been described in patients' photo‐allergic to ketoprofen, 10 the latter also being a benzophenone derivative, similar to benzophenone‐3 (oxybenzone) and diethylamino hydroxybenzoyl hexyl benzoate (Figure S1). Although this might indicate potential cross‐reactivity between these filters, and relate to associated co‐sensitizations to these particular fragrances, our patient was not shown to be photo‐allergic to ketoprofen nor to benzophenone‐3.…”

Contact allergy to oxidised geraniol may be over‐represented in individuals with photocontact allergy to ketoprofen

“…It may look like the overrepresentation of simultaneous contact allergy in ketoprofen‐photoallergic individuals only concerns fragrance materials. However, a recent publication presents data on overrepresentation of contact allergy to non‐fragrance materials in individuals with photocontact allergy to ketoprofen compared to dermatitis patients and the general population 4 . Black rubber mix, budesonide, para‐tertiary butyl phenol‐formaldehyde resin (PTBP‐F‐R) and PFR‐2, a resol resin based on phenol and formaldehyde, 17 were overrepresented with the highest odds ratios for PTBP‐F‐R and PFR‐2 4 …”

“…An overrepresentation of simultaneous contact allergies including balsam of Peru, fragrance mix I and cinnamic alcohol have been known since many years in patients with photocontact allergy to the non‐steroidal anti‐inflammatory drug (NSAID) ketoprofen 1 . For the eight fragrance materials in fragrance mix I, the overrepresentation of contact allergy was not only expectedly noted for cinnamic alcohol but also for cinnamal, eugenol and isoeugenol 2 . Furthermore, the fragrance‐related sensitisers oxidised (ox.)…”

“…limonene have been added to the list of overrepresented contact allergies in patients with photocontact allergy to ketoprofen 3 . Recently, contact allergy to non‐fragrance contact sensitisers in the baseline patch test series was reported to be overrepresented in ketoprofen‐photoallergic patients 4 …”

“…test series was reported to be overrepresented in ketoprofenphotoallergic patients. 4 The aim of this study was to investigate whether there is any association between photocontact allergy to ketoprofen and simultaneous contact allergy to ox. geraniol as well as to the chemically related fragrance materials geraniol, geranial, neral and citral.…”