title: Lyral is an important sensitizer in patients sensitive to fragrances.
abstract: Contact allergy to fragrances is a common problem world-wide. The currently used fragrance mix (FM) for patch testing has only eight constituents and does not identify all fragrance-allergic patients. As perfumes may contain 100 or more substances, the search for markers for allergy continues. The synthetic fragrance 4-(4-hydroxy-4-methylpentyl)-3-cyclohexene carboxaldehyde (Lyral) was tested together with the FM and 11 other fragrance substances on consecutive patients in six European departments of dermatology. All patients were carefully questioned regarding a history of reactions to scented products in the past and were grouped into four categories: 'certain', 'probable', 'questionable' and 'none'. Lyral (5% in petrolatum) gave a positive reaction in 2.7% of 1855 patients (range 1.2-17%) and ranked next to 11.3% with FM allergy. Twenty-four patients reacted to both Lyral and FM, but 21 (1.1%) reacted positively only to Lyral. Of 124 patients with a 'certain' history, 53.2% reacted to the FM and a further 7.2% to Lyral only. If any kind of history of fragrance intolerance was given, 80% (40 of 50) of Lyral positive patients had a 'positive' history while only 58.6% (123 of 210) of FM positive patients had such a history; this difference was significant at P < 0.01. Lyral was identified by gas chromatography-mass spectrometry in some products which had caused an allergic contact dermatitis in four typical patients who showed a patch test positive to Lyral and negative or doubtful to FM. In conclusion, we recommend the testing of 5% Lyral (in petrolatum) in patients suspected of contact dermatitis.
authors.affiliation: Department of Dermatology, Städtische Kliniken Dortmund and University of Witten/Herdecke, Germany. stkd.hautklinik@dokom.net
authors.forename: P J
authors.initials: PJ
authors.lastname: Frosch
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
authors.forename: T
authors.initials: T
authors.lastname: Menné
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: J P
authors.initials: JP
authors.lastname: Lepoittevin
authors.forename: E
authors.initials: E
authors.lastname: Giménez Arnau
authors.forename: C
authors.initials: C
authors.lastname: Pirker
authors.forename: A
authors.initials: A
authors.lastname: Goossens
authors.forename: I R
authors.initials: IR
authors.lastname: White
mesh_terms: D000328:Adult; D000447:Aldehydes / Q000009:adverse effects* / Q000276:immunology; D000485:Allergens / Q000009:adverse effects*; D053138:Cyclohexenes; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods; D010476:Perfume / Q000009:adverse effects*
chemical_list: D000447:Aldehydes; D000485:Allergens; D053138:Cyclohexenes; D010476:Perfume; C092244:hydroxyisohexyl 3-cyclohexene carboxaldehyde