title: Testing with fragrance mix. Is the addition of sorbitan sesquioleate to the constituents useful?
abstract: In a multicentre study, the value of adding sorbitan sesquioleate (SSO) to the constituents of the 8% fragrance mix (FM) was investigated. In 7 centres, 709 consecutive patients were tested with 2 types of FM from different sources, its 8 constituents with 1% SSO, its 8 constituents without SSO, and 20% SSO. 5 patients (0.71%) reacted to the emulsifier SSO itself, read as definitely allergic on day 3/4. 53 patients reacted to either one of the mixes with an allergic type of reaction. When tested with the constituents without SSO, 41.5% showed an allergic reaction versus 54.7% with SSO. If both types of reactions were considered (allergic and irritant) 38.3% of 73 patients showed a positive "breakdown" result without SSO, versus 54.8% with SSO. The differences were statistically significant. Reactivity to FM constituents was changed in a specific pattern by addition of SSO--irritant reactions increased, particularly for cinnamic alcohol, eugenol, geraniol, oak moss and hydroxycitronellal, whereas others showed only a slight change. Allergic reactions were also increased by SSO, but the rank order of the top 3 sensitizers (isoeugenol, oak moss and eugenol) did not change. Cinnamic alcohol was the only constituent with decreased reactivity after addition of SSO. A positive history of fragrance sensitivity (HFS) was clearly associated with a positive allergic reaction to either the mix or 1 of its constituents (51% versus 28.6% with a negative HFS). Irritant reactions were linked to a negative HFS in a high proportion (64.3%).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Dermatology, Städtische Kliniken Dortmund, Germany.
authors.forename: P J
authors.initials: PJ
authors.lastname: Frosch
authors.forename: B
authors.initials: B
authors.lastname: Pilz
authors.forename: D
authors.initials: D
authors.lastname: Burrows
authors.forename: J G
authors.initials: JG
authors.lastname: Camarasa
authors.forename: J M
authors.initials: JM
authors.lastname: Lachapelle
authors.forename: A
authors.initials: A
authors.lastname: Lahti
authors.forename: T
authors.initials: T
authors.lastname: Menné
authors.forename: J D
authors.initials: JD
authors.lastname: Wilkinson
mesh_terms: D000485:Allergens; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000276:immunology*; D006601:Hexoses / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D010328:Patch Tests / Q000379:methods; D010476:Perfume / Q000009:adverse effects / Q000737:chemistry; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000485:Allergens; D006601:Hexoses; D010476:Perfume; C058854:sorbitan sesquioleate