Oxidized citrus oil (R-limonene): a frequent skin sensitizer in Europe.
BACKGROUND
Peel oil from citrus fruits consists of R-(+)-limonene, which is one of the most commonly used fragrance materials in technical products and in fine fragrances. This substance forms allergenic oxidation products during handling and storage.


OBJECTIVE
We wanted to study the frequency of allergic reactions to oxidized R-(+)-limonene in patients with dermatitis and find a suitable test preparation.


METHODS
Patch testing with oxidized R-(+)-limonene was performed on 2273 patients at 4 dermatology clinics in Europe.


RESULTS
Of the consecutive patients tested, 3.8% to 3.9% had positive reactions in two of the clinics; 6.5% had positive reactions in the third clinic; and 0.3% had positive reactions in the fourth clinic. A total of 63 patients showed positive reactions. In total, 57% of the patients did not react to fragrance mix or balsam of Peru. We recommend testing with 3% oxidized R-(+)-limonene in patients referred for patch testing.


CONCLUSIONS
The high frequency of oxidized limonene allergy provides clinical evidence for the European classification of R-(+)-limonene that contains oxidation products as skin sensitizers.
Matura
Mihály
M
Occupational Dermatology, National Institute for Working Life, Stockholm, Sweden.
Goossens
An
A
Bordalo
Olivia
O
Garcia-Bravo
Begoña
B
Magnusson
Kerstin
K
Wrangsjö
Karin
K
Karlberg
Ann-Therese
AT
D003358:Cosmetics; D053138:Cyclohexenes; D005060:Europe; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D000077222:Limonene; D008297:Male; D010328:Patch Tests; D013729:Terpenes / Q000276:immunology*
D003358:Cosmetics; D053138:Cyclohexenes; D013729:Terpenes; D000077222:Limonene