title: Relevance of positive patch-test reactions to fragrance mix.
abstract: BACKGROUND
  Fragrances are an important cause of allergic contact dermatitis. We presume that the traditional fragrance mix (FM) detects 70 to 80% of fragrance-allergic patients. FM has an irritant potential. Weak positive reactions may have a greater chance of being irrelevant than strong reactions.
  
  
  OBJECTIVE
  To improve the appraisal of FM patch-test reactions, we studied the relevance of reactions of different strength. We also studied the predictive value of the following on the relevance of the initial FM patch-test results: patch-test results of a repeated FM test; results of patch tests with balsam of Peru, colophony, and ingredients of the mix; and (history of) atopic dermatitis.
  
  
  METHODS
  One hundred thirty-eight patients who had doubtful positive (?+) or positive (+ to +++) reactions were included in the study. We determined relevance by history taking, location and course of the dermatitis, and additional patch testing. Patients were retested with FM and with each ingredient separately.
  
  
  RESULTS
  The relevance of reactions to FM increases with the strength of the reactions. Predictors of relevance are the results of retesting with FM, the results of tests with the ingredients, and a history and/or present symptoms of atopic dermatitis.
  
  
  CONCLUSIONS
  Retesting with FM and its ingredients may add to the benefit of patch testing.
authors.affiliation: Department of Dermatology, Hospital H. Serruys, Ostend, Belgium.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Devos
authors.forename: Lieve
authors.initials: L
authors.lastname: Constandt
authors.forename: Ron A
authors.initials: RA
authors.lastname: Tupker
authors.forename: Kathy C
authors.initials: KC
authors.lastname: Noz
authors.forename: Georges P H
authors.initials: GP
authors.lastname: Lucker
authors.forename: Derk P
authors.initials: DP
authors.lastname: Bruynzeel
authors.forename: Marie-Louise A
authors.initials: ML
authors.lastname: Schuttelaar
authors.forename: Mente R J
authors.initials: MR
authors.lastname: Kruyswijk
authors.forename: Esther J
authors.initials: EJ
authors.lastname: van Zuuren
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Vink
authors.forename: Pieter-Jan
authors.initials: PJ
authors.lastname: Coenraads
authors.forename: Lambertus A L M
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: Pieter G M
authors.initials: PG
authors.lastname: van der Valk
mesh_terms: D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology*; D004305:Dose-Response Relationship, Drug; D005060:Europe; D005260:Female; D006795:Household Products / Q000633:toxicity; D006801:Humans; D007509:Irritants / Q000009:adverse effects; D008297:Male; D008452:Maximum Allowable Concentration; D010328:Patch Tests; D010476:Perfume / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D000485:Allergens; D007509:Irritants; D010476:Perfume