title: The fragrance hand immersion study - an experimental model simulating real-life exposure for allergic contact dermatitis on the hands.
abstract: Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p.p.m.), whilst during the following 2 weeks, the concentration was relatively high (approximately 250 p.p.m.), imitating real-life exposure to a household product like dishwashing liquid diluted in water and the undiluted product, respectively. Evaluation was made using a clinical scale and laser Doppler flow meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger in a solution containing fragrance and development of clinically visible eczema on the finger in 15 participants previously diagnosed with hand eczema and with a positive patch test to the fragrance in question.
authors.affiliation: Department of Dermatology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. sihe@gentoftehosp.kbhamt.dk
authors.forename: S
authors.initials: S
authors.lastname: Heydorn
authors.forename: T
authors.initials: T
authors.lastname: Menné
authors.forename: K E
authors.initials: KE
authors.lastname: Andersen
authors.forename: M
authors.initials: M
authors.lastname: Bruze
authors.forename: C
authors.initials: C
authors.lastname: Svedman
authors.forename: D
authors.initials: D
authors.lastname: Basketter
authors.forename: J D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000328:Adult; D000447:Aldehydes / Q000008:administration & dosage* / Q000009:adverse effects; D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects; D053138:Cyclohexenes; D017449:Dermatitis, Allergic Contact; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004781:Environmental Exposure; D005260:Female; D005385:Fingers; D006229:Hand Dermatoses; D006801:Humans; D007101:Immersion; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010328:Patch Tests; D010476:Perfume / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013729:Terpenes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000447:Aldehydes; D000485:Allergens; D053138:Cyclohexenes; D010476:Perfume; D013729:Terpenes; C020755:hydroxycitronellal; C092244:hydroxyisohexyl 3-cyclohexene carboxaldehyde