Allergic contact dermatitis from fragrance components in specific topical pharmaceutical products in Belgium.
OBJECTIVE
To determine which topical pharmaceutical products marketed in Belgium contain fragrances and to examine the nature of the fragrance allergens in specific pharmaceutical products having caused iatrogenic contact dermatitis.


METHODS
All topical pharmaceutical products marketed in Belgium, that is 3820 products, were examined as to their fragrance content as labelled. Data of 18, 960 patients investigated for contact allergy between 1978 and 2008 were retrieved from our database, including information on the nature of the topical pharmaceutical products used, the results of patch tests, and the sensitization sources.


RESULTS
Three hundred and seventy (10%) of 3280 of the topical pharmaceutical products were found to contain a total of 66 fragrance substances. Among 3378 patients suffering from iatrogenic allergic contact dermatitis, 127 were found to react to 48 specific products, for which 38 different fragrance substances gave relevant positive reactions. Women were more affected than men, and legs, hands, and face were the most commonly affected body sites.


CONCLUSIONS
Fragrances, the presence of which is in most cases unnecessary, do contribute to iatrogenic allergic contact dermatitis. Moreover, sensitized patients have difficulties in avoiding their specific allergens because standardized labelling of the ingredients in pharmaceutical products is lacking.
Nardelli
Andrea
A
Department of Dermatology, University Hospital, Katholieke Universiteit Leuven, Leuven, Belgium.
D'Hooghe
Ellen
E
Drieghe
Jacques
J
Dooms
Marc
M
Goossens
An
A
D000287:Administration, Topical; D000328:Adult; D000485:Allergens / Q000032:analysis; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D064420:Drug-Related Side Effects and Adverse Reactions; D005145:Face; D005260:Female; D006225:Hand; D006801:Humans; D007866:Leg; D008297:Male; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects* / Q000032:analysis*; D004364:Pharmaceutical Preparations / Q000737:chemistry*; D012189:Retrospective Studies; D012737:Sex Factors
D000485:Allergens; D010476:Perfume; D004364:Pharmaceutical Preparations