title: The role of the skin irritation response in polysensitization to fragrances.
abstract: BACKGROUND
  Contact allergy to fragrance chemicals is an increasing problem. Polysensitization is likely to be a phenotype of increased susceptibility to contact allergy. The factors that play a role in polysensitization are largely unknown. Identifying these risk factors is important with regard to future studies on the aetiology of contact allergy.
  
  
  OBJECTIVE
  To investigate whether enhanced skin irritability is a risk factor for the development of polysensitization to fragrance chemicals.
  
  
  METHODS
  One hundred participants characterized by fragrance contact allergy were included in our study. The participants were patch tested on the back with 25 individual fragrance chemicals and fragrance mixes I and II, and on the upper arm with sodium lauryl sulfate (SLS) (consisting of SLS concentrations of 0.45%, 0.67%, 1%, and 1.5%). Reading of both tests was performed during the following visits at days 2, 3, and 7. The response to SLS was monitored by measuring transepidermal water loss (TEWL). Polysensitization was defined as three or more allergic reactions to non-cross-reacting fragrance chemical allergens.
  
  
  RESULTS
  Individuals with polysensitization showed significantly higher irritation responses to SLS 1% and 1.5% as assessed by TEWL.
  
  
  CONCLUSIONS
  We found an enhanced skin irritation response to be a risk factor for the development of polysensitization to fragrance chemicals.
authors.affiliation: Department of Dermatology, VU University Medical Centre, Amsterdam 1081 HV, The Netherlands.
authors.forename: Mariette J C
authors.initials: MJ
authors.lastname: Nagtegaal
authors.forename: Stefanie E
authors.initials: SE
authors.lastname: Pentinga
authors.forename: Joop
authors.initials: J
authors.lastname: Kuik
authors.forename: Sanja
authors.initials: S
authors.lastname: Kezic
authors.forename: Thomas
authors.initials: T
authors.lastname: Rustemeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007509:Irritants / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects*; D012307:Risk Factors; D012720:Severity of Illness Index; D023422:Skin Irritancy Tests; D012967:Sodium Dodecyl Sulfate / Q000009:adverse effects; D014870:Water Loss, Insensible; D055815:Young Adult
chemical_list: D000485:Allergens; D007509:Irritants; D010476:Perfume; D012967:Sodium Dodecyl Sulfate