Relevance of positive patch-test reactions to fragrance mix.
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.
Devos
Steven A
SA
Department of Dermatology, Hospital H. Serruys, Ostend, Belgium.
Constandt
Lieve
L
Tupker
Ron A
RA
Noz
Kathy C
KC
Lucker
Georges P H
GP
Bruynzeel
Derk P
DP
Schuttelaar
Marie-Louise A
ML
Kruyswijk
Mente R J
MR
van Zuuren
Esther J
EJ
Vink
Jaqueline
J
Coenraads
Pieter-Jan
PJ
Kiemeney
Lambertus A L M
LA
van der Valk
Pieter G M
PG
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
D000485:Allergens; D007509:Irritants; D010476:Perfume