Positive patch test reactions to lanolin: cross-sectional data from the north american contact dermatitis group, 1994 to 2006.
BACKGROUND
The prevalence of lanolin sensitivity in referred patients is less than 4%.


OBJECTIVE
To (1) describe patients with positive patch-test reactions to lanolin, (2) determine clinical and occupational relevance associated with reactions to lanolin and common sources, and (3) examine the frequency of co-reacting allergens.


METHODS
A retrospective analysis of 26,479 patients patch-tested by the North American Contact Dermatitis Group (NACDG), 1994 to 2006.


RESULTS
Overall, 2.5% of patients (643 of 25,811) tested to lanolin alcohol 30% in petrolatum had positive reactions. Prevalence decreased from 3.7% in 1996 to 1998 to 1.8% in 2005 to 2006 (p <.0001); 83.4% of all positive reactions were currently relevant, but only 2.5% were occupationally relevant. Lanolin-positive patients were 1.2 times more likely to be male and 1.4 times more likely to have a history of atopic dermatitis when compared to allergic, but lanolin-negative, patients (p < .0002 and p < .0001, respectively). Cosmetics were the most common source. Lanolin-positive patients were significantly more likely to be co-sensitized to another NACDG standard screening allergen (p <.0001).


CONCLUSIONS
The prevalence of allergic patch-test reactions to lanolin in North America patch-test populations is decreasing. Current relevance of reactions was high, but occupational relevance was low. Concomitant reactions were more common in lanolin-positive patients.
Warshaw
Erin M
EM
Veterans Affairs Medical Center, Minneapolis, MN, USA.
Nelsen
David D
DD
Maibach
Howard I
HI
Marks
James G
JG
Zug
Kathryn A
KA
Taylor
James S
JS
Rietschel
Robert L
RL
Fowler
Joseph F
JF
Mathias
C G Toby
CG
Pratt
Melanie D
MD
Sasseville
Denis
D
Storrs
Frances J
FJ
Belsito
Donald V
DV
DeLeo
Vincent A
VA
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000485:Allergens; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology; D009783:Dermatitis, Occupational / Q000453:epidemiology / Q000209:etiology*; D003880:Dermatology; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007809:Lanolin / Q000009:adverse effects*; D007868:Leg Dermatoses / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D010328:Patch Tests / Q000379:methods*; D015995:Prevalence; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012955:Societies, Medical
D000485:Allergens; D007809:Lanolin