Quantitative patch and repeated open application testing in hydroxyisohexyl 3-cyclohexene carboxaldehyde sensitive-patients.
OBJECTIVE
To identify the concentration of the fragrance compound hydroxyisohexyl 3-cyclohexene carboxaldehyde (INCI) (HICC) that is sufficiently low not to cause an allergic reaction in patients with proven sensitization.


METHODS
Repeated open application testing (ROAT) in 64 subjects with 2 preparations (perfume and cream) in different concentration (0.005-2.5%). Confirmatory patch testing with four preparations in two different concentrations (2.5% and 5%).


RESULTS
The concentrations of HICC being tolerated by 90% of those sensitized to HICC are estimated as <88.2 ppm (cream) and <270 ppm (perfume) equivalent to 1.2 microg/cm(2) (perfume) and 4.9 microg/cm(2) (cream). Patch test preparations differed with regard to sensitivity (88.5-98.1%) and specificity (37.5-87.5%) against the ROAT result as external criterion. ROAT concentrations and the reaction strength in patch testing were inversely correlated (Kendall's tau-b: 0.69), both indicating the existence of different degrees of susceptibility.


CONCLUSIONS
To protect 90% (50%) of people sensitized, the use concentration should be in the range of 0.009-0.027% (0.18-0.34%), depending on the product type. Taking into account these results, excessive concentrations should be avoided, as this would continue to sensitize people. Close monitoring is indispensable to prove the efficacy of any recommendations aiming to prevent induction.
Schnuch
Axel
A
Information Network of Departments of Dermatology, University of Göttingen, Göttingen/Germany. aschnuch@med.uni-goettingen.de
Uter
Wolfgang
W
Dickel
Heinrich
H
Szliska
Christiane
C
Schliemann
Sibylle
S
Eben
Ricarda
R
Ruëff
Franziska
F
Gimenez-Arnau
Ana
A
Löffler
Harald
H
Aberer
Werner
W
Frambach
Yvonne
Y
Worm
Margitta
M
Niebuhr
Margarete
M
Hillen
Uwe
U
Martin
Vera
V
Jappe
Uta
U
Frosch
Peter J
PJ
Mahler
Vera
V
D000447:Aldehydes / Q000008:administration & dosage / Q000009:adverse effects*; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects*; D053138:Cyclohexenes / Q000008:administration & dosage / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D005060:Europe; D006801:Humans; D009824:Ointments; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects* / Q000737:chemistry; D012680:Sensitivity and Specificity
D000447:Aldehydes; D000485:Allergens; D053138:Cyclohexenes; D009824:Ointments; D010476:Perfume