Reactions in selected patients to 22 fragrance materials

Malten, K. E.; Ketel, W. G. van; Jp, Nater; Liem, D. H.

doi:10.1111/j.1600-0536.1984.tb00162.x

Cited by 93 publications

(33 citation statements)

References 37 publications

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“…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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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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“…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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“…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%

“…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]. However, in a recent study on the skin reactivity to 14 frequently used chemicals, Frosch et al [14] observed positive patch tests to coumarin in less than 0.3% of the 1,855 ACD patients tested.…”

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 incidence of contact sensitization to rubber chemicals is so high in the general population that some 16 of them have been incorporated in the screening series of contact allergens of the International Contact Dermatitis Research Group (Malten et al 1976, Fregert 1974. The frequency with which allergen replacement is demanded by surgeons indicates that contact sensitization to these auxiliary substances is frequent among them, but in addition it can be rather serious if replacement is really impossible in certain cases.…”

mentioning

confidence: 99%