title: Clinical relevance of positive patch test reactions to the 26 EU-labelled fragrances.
abstract: 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.
authors.affiliation: Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. e.j.van.oosten@derm.umcg.nl
authors.forename: Eleonoor J
authors.initials: EJ
authors.lastname: van Oosten
authors.forename: Marie-Louise A
authors.initials: ML
authors.lastname: Schuttelaar
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: Coenraads
mesh_terms: 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*
chemical_list: D010476:Perfume