Clinical relevance of positive patch test reactions to the 26 EU-labelled fragrances.
BACKGROUND
Fragrance mix I (FM I) and fragrance mix II (FM II) in the European baseline series are used as screening tools for fragrance contact allergy. In 2005 the European Union (EU) required labelling of 26 fragrances when present in cosmetic products. INCI nomenclature is obligatory for such labelling.


OBJECTIVE
To describe frequencies of contact allergy to these 26 fragrance substances, and to evaluate clinical relevance of these positive reactions.


METHODS
Three hundred and twenty patients with eczema suspected of being contact allergy to fragrances or cosmetics were patch tested with the EU-declared fragrance chemicals, FM I and FM II.


RESULTS
There were 76 positive reactions in 33 patients. Most reactions were seen to [corrected] hydroxyisohexyl 3-cyclohexene carboxaldehyde in 3.1%, followed by Evernia furfuracea (2.5%) and cinnamyl alcohol (2.5%). Twelve reactions to FM I and II were not confirmed by separate ingredients. Clinical relevance of positive reactions to fragrances was certain in 20/33 (61%).


CONCLUSIONS
10.3% of the patients had positive patch tests in the EU-list. Hydroxyisohexyl 3-cyclohexene carboxaldehyde, a component of FM II, was the most frequent allergen, followed by Evernia furfuracea. Since Evernia furfuracea is not part of FM I or FM II, relevant reactions can be missed when only the European baseline series is used.
van Oosten
Eleonoor J
EJ
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. e.j.van.oosten@derm.umcg.nl
Schuttelaar
Marie-Louise A
ML
Coenraads
Pieter Jan
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000276:immunology; D005062:European Union; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods*; D010476:Perfume / Q000009:adverse effects*
D010476:Perfume