Sensitization to fragrances in Spain: A 5-year multicentre study (2011-2015)

Contact Dermatitis. 2019 Feb;80(2):94-100. doi: 10.1111/cod.13152. Epub 2018 Nov 14.

Abstract

Background: Fragrance chemicals constitute the second most frequent cause of contact allergy in Spain. There are no data available concerning the individual fragrances that are most frequently involved.

Objectives: To describe the diagnostic contribution provided by specific fragrance series to the results obtained with baseline series fragrance markers by correlating the results of both series.

Materials and methods: We performed a 5-year retrospective study of fragrance marker-positive patients tested with specific fragrance series in 23 Spanish centres. We collected the demographic and clinical characteristics, and compared the results of patch tests obtained from different suppliers.

Results: Of 19 588 patients patch tested with the Spanish baseline series, 1590 (8.1%) reacted positively to a fragrance marker. Of these, 1013 (63.7%) were patch tested with a fragrance series, and 664 patients reacted positively to at least one individual fragrance other than hydroxyisohexyl 3-cyclohexene carboxaldehyde. Geraniol was the most frequent allergen. Positive reactions to substances not included in fragrance mix (FM) I or FM II were found in 230 patients. Of the 436 FM I-positive patients and the 419 FM II-positive patients, 184 (42%) and 64 (39.1%), respectively, had no positive reactions to fragrance series. In the case of FM I, negative results were more common when individual fragrances were patch tested at low concentrations.

Conclusions: We recommend patch testing all patients positive for any fragrance marker with a specific fragrance series. The correlation between the results of baseline series and fragrance series could be improved by increasing the concentrations of individual fragrances.

Keywords: RRID:SCR_001905; allergic contact dermatitis; epidemiology; fragrances; patch test.

Publication types

  • Multicenter Study

MeSH terms

  • Acyclic Monoterpenes
  • Adult
  • Aged
  • Aged, 80 and over
  • Aldehydes / adverse effects
  • Anti-Infective Agents / adverse effects
  • Coumarins / adverse effects
  • Cyclohexenes / adverse effects
  • Dermatitis, Allergic Contact / epidemiology*
  • Dermatitis, Allergic Contact / etiology
  • Dermatitis, Occupational / epidemiology*
  • Dermatitis, Occupational / etiology
  • Eugenol / adverse effects
  • Eugenol / analogs & derivatives
  • Facial Dermatoses / epidemiology*
  • Facial Dermatoses / etiology
  • Farnesol / adverse effects
  • Female
  • Hand Dermatoses / epidemiology*
  • Hand Dermatoses / etiology
  • Humans
  • Leg Dermatoses / epidemiology*
  • Leg Dermatoses / etiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Monoterpenes / adverse effects
  • Myroxylon / adverse effects
  • Patch Tests
  • Perfume / adverse effects*
  • Propanols / adverse effects
  • Retrospective Studies
  • Spain / epidemiology
  • Terpenes / adverse effects

Substances

  • Acyclic Monoterpenes
  • Aldehydes
  • Anti-Infective Agents
  • Coumarins
  • Cyclohexenes
  • Monoterpenes
  • Perfume
  • Propanols
  • Terpenes
  • Eugenol
  • Farnesol
  • isoeugenol
  • hydroxycitronellal
  • coumarin
  • geraniol
  • citronellol
  • hydroxyisohexyl 3-cyclohexene carboxaldehyde
  • cinnamyl alcohol
  • citral