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Research: KATSAROU and colleagues,
Listed in Issue 44
Abstract
KATSAROU and colleagues, Department of Dermatology, University of Athens, A. Sygros Hospital, Greece write that the most common reaction to fragrances is contact dermatitis, a delayed hypersensitivity reaction; other reactions include immediate contact reactions such as contact urticaria and photo-allergic reactions . The authors used fragrance mix (FM) and balsam of Peru (BP) to screen for fragrance allergy, in order to study different types of allergic skin reactions to fragrance compounds.
Background
Methodology
The authors studied delayed hypersensitivity reactions to FM and BP in 4,975 patients with suspected contact dermatitis using routine patch testing. Results were interpreted at 48 and 96 hours. In 664 of the patients, the patch tests were read at 30 minutes in order to evaluate for immediate contact reactions, and again at 48 and 96 hours. In 111 patients suspected of having photo-allergic dermatitis, photopatch tests to FM were performed.
Results
There were delayed contact reactions to FM in 6.6% of females and 5.4% of males; to BP in 3.9% of females and 4.1% of males. Over 12 study years, there was an increased trend for reactions to fragrances, particularly in males. In 62% of patients, there was sensitivity to other contact allergens (polysensitivity), which presented more often with generalised contact dermatitis. The most sensitising components of the fragrance mix tested in 38 patients were cinnamic alcohol, oak moss, and cinnamic aldehyde . There were 112 immediate patch test reactions to FM and 113 to BP in 664 patients. Delayed contact reactions followed immediate contact reactions in 13.4% of patients for FM and 8.8% for BP. This represented a significant increase in the frequency of delayed contact reactions. However, patients with immediate contact reactions to fragrances did not have a higher incidence of atopy (25.9%). There were no cases seen of positive photopatch test reactions to FM.
Conclusion
Fragrances commonly cause both delayed and immediate patch test reactions. Patients with immediate contact reactions have an increase in delayed contact reactions to the same allergen.
References
Katsarou A et al. Contact reactions to fragrances. Annals of Allergy, Asthma, and Immunology 82(5): 449-55. May 1999.
