title: Patch test reactivity to feverfew-containing creams in feverfew-allergic patients.
abstract: BACKGROUND
  The Compositae plant feverfew (Tanacetum parthenium) has long been recognized as an important sensitizer in European Compositae-allergic patients, mainly because of its content of the sesquiterpene lactone parthenolide. Recently, a parthenolide-depleted feverfew extract with claimed anti-inflammatory properties has been developed for use in cosmetics.
  
  
  OBJECTIVE
  The aim of the study was to test, on the basis of patch test reactions, whether persons with contact allergy to feverfew could tolerate creams containing this feverfew extract.
  
  
  METHODS
  Seven patients with feverfew contact allergy were patch tested with two creams containing the feverfew extract. Subsequently, the creams were analysed by liquid chromatography with tandem mass spectrometry to detect parthenolide.
  
  
  RESULTS
  Four of the patients tested positive to one of the creams; reactivity was associated with simultaneous positive reactions to parthenolide. This cream was analysed about 2 years later, and no parthenolide was detected, probably because of degradation of the compound.
  
  
  CONCLUSIONS
  Topical products containing parthenolide-depleted feverfew extracts may elicit positive patch test reactions in feverfew-sensitive patients. The reactivity may be enhanced by simultaneous testing with parthenolide, but the reactivity is lost over time, probably because of degradation of parthenolide.
authors.affiliation: Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, DK-5000 Odense C, Denmark.
authors.forename: Evy
authors.initials: E
authors.lastname: Paulsen
authors.forename: Lars P
authors.initials: LP
authors.lastname: Christensen
authors.forename: Xavier C
authors.initials: XC
authors.lastname: Fretté
authors.forename: Klaus E
authors.initials: KE
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010328:Patch Tests; D010936:Plant Extracts / Q000009:adverse effects*; D012717:Sesquiterpenes / Q000737:chemistry; D020903:Tanacetum parthenium / Q000009:adverse effects*
chemical_list: D009824:Ointments; D010936:Plant Extracts; D012717:Sesquiterpenes; C002669:parthenolide