Simultaneous patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes: An update from southern Sweden

Abstract

Background: Regularly updating the prevalence of fragrance contact allergy (CA) is important. Patch testing with fragrance markers in the baseline series and the ingredients of fragrance mixes (FMs) is still debated.Objectives: To update the prevalence and clinical characteristics of patients with fragrance CA. To establish the results of patch testing with individual allergens of FMs.Methods: A retrospective analysis of 3539 patients with dermatitis who were patch tested with the baseline series and FMs ingredients during 2016 to 2020 was performed.Results: The prevalence of fragrance CA was 13%. About 10% of these patients with fragrance CA would be missed if the individual ingredients were not tested. Unlike hydroxyisohexyl 3-cyclohexene carboxaldehyde, there was no decreasing trend of CA to Evernia prunastri (oakmoss) extract after the EU regulation came into force.Patients with CA from only one ingredient of the mixes or having a weak positive reaction to the ingredients were significantly missed when tested with only the fragrance markers in the baseline series.

Contact sensitizations in massage therapists with occupational contact dermatitis: Patch test data of the Information Network of Departments of Dermatology, 2008–2020

“…Most of them were identified by testing the single constituents of fragrance mixes I and II. This is in line with a recent study showing that about 10% of patients with sensitization to fragrances would have been missed if only the fragrance mixes had been patch tested and not their constituents 41 . Therefore, it is recommended in patients with suspected fragrance allergy, including massage therapists with hand dermatitis, to routinely test a broad spectrum of fragrances and essential oils.…”

“…if only the fragrance mixes had been patch tested and not their constituents. 41 Therefore, it is recommended in patients with suspected fragrance allergy, including massage therapists with hand dermatitis, to routinely test a broad spectrum of fragrances and essential oils.…”

Use of sorbitan sesquioleate in patch test preparations and patch testing with the substance—What do our results mean?

“…Of all patients, 221, 250 and 77 had a positive reaction to FM I, BOP and oakmoss extract, respectively. Detailed information about these patients was reported 14 . Regarding patients with contact allergy to FM I, the proportion of patients with concomitant positive reactions to SSO and FM I was 3.2%, whereas 4.0% and 10.4% of the patients with positive reactions to BOP and oakmoss extract had a concomitant reaction to SSO (Table 2).…”

“…had been situated in our extended baseline series, used for patch testing in every consecutive dermatitis patient. Individual FM I constituents used for patch testing were previously described 14 . Fragrance test preparations that contain 5% SSO as an emulsifier at our clinic were BOP, FM I and oakmoss extract 12 .…”

“…Demographic data of the patients, including age, gender, and a history of atopic dermatitis (AD, having childhood eczema diagnosed with AD), were collected. Patient inclusion, allergens, patch test procedures and readings at the clinic were conducted according to the recommended guidelines of the International Contact Dermatitis Research Group (ICDRG) 15 and the European Society for Contact Dermatitis, 16 described in published 14,17 Patch test reading was performed on Day (D) 3 or 4, and D7. The intensity of the reaction was read as negative, doubtful, weakly positive (1+), strongly positive (2+), extremely positive (3+) and irritant.…”