title: Deodorants: a clinical provocation study in fragrance-sensitive individuals.
abstract: Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance-sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance-mix-sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in those deodorants. 14 eczema patients performed a 7-day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 applications per day were made in the axilla and simultaneously on a 25 cm2 area on the upper arm. A total of 20 deodorants were tested among the 14 patients. Afterwards, the deodorants were subjected to quantitative chemical analysis identifying constituents of the fragrance mix. 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both in the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis revealed that 18/19 deodorants contained between 1 and 6 of the fragrance-mix constituents, on average 3 being found. The mean concentration of fragrance-mix constituents was generally higher in the deodorants causing a positive use test, as compared with those giving a negative reaction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use test on the upper arm and a strong clinical suspicion.
authors.affiliation: Department of Dermatology, Gentofte Hospital, University of Copenhagen, Denmark.
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
authors.forename: S C
authors.initials: SC
authors.lastname: Rastogi
authors.forename: M
authors.initials: M
authors.lastname: Bruze
authors.forename: K E
authors.initials: KE
authors.lastname: Andersen
authors.forename: P
authors.initials: P
authors.lastname: Frosch
authors.forename: B
authors.initials: B
authors.lastname: Dreier
authors.forename: J P
authors.initials: JP
authors.lastname: Lepoittevin
authors.forename: I
authors.initials: I
authors.lastname: White
authors.forename: T
authors.initials: T
authors.lastname: Menné
mesh_terms: D000485:Allergens / Q000009:adverse effects; D003836:Deodorants / Q000009:adverse effects / Q000032:analysis* / Q000737:chemistry; D017449:Dermatitis, Allergic Contact / Q000209:etiology; D004485:Eczema / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D010328:Patch Tests / Q000379:methods; D010476:Perfume / Q000009:adverse effects; D012867:Skin / Q000187:drug effects / Q000473:pathology
chemical_list: D000485:Allergens; D003836:Deodorants; D010476:Perfume