title: Patch test reactions associated with sunscreen products and the importance of testing to an expanded series: retrospective analysis of North American Contact Dermatitis Group data, 2001 to 2010.
abstract: BACKGROUND
  Both active and inactive ingredients in sunscreen may cause contact dermatitis.
  
  
  OBJECTIVE
  This study aimed to describe allergens associated with a sunscreen source.
  
  
  METHODS
  A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 2001 and 2010 was performed.
  
  
  RESULTS
  Of 23,908 patients patch tested, 219 (0.9%) had sunscreen coded as an allergen source. Patients who were male, with occupational dermatitis, or older (older than 40 years) had significantly lower rates of allergic reactions to sunscreens; the most commonly affected areas were the face and exposed sites (P < 0.0001). The top 3 most frequent allergens in sunscreens were benzophenone-3 (70.2% for 10% concentration, 64.4% for 3% concentration), DL-alpha-tocopherol (4.8%), and fragrance mix I (4.0%). Less than 40% of positive patch test reactions were detected by the North American Contact Dermatitis Group screening series of 65 to 70 allergens.
  
  
  CONCLUSIONS
  A supplemental antigen series is important in detecting allergy to sunscreens.
authors.affiliation: Department of Dermatology, Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN 55417, USA. erin.warshaw@va.gov
authors.forename: Erin M
authors.initials: EM
authors.lastname: Warshaw
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: Wang
authors.forename: Howard I
authors.initials: HI
authors.lastname: Maibach
authors.forename: Donald V
authors.initials: DV
authors.lastname: Belsito
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Zug
authors.forename: James S
authors.initials: JS
authors.lastname: Taylor
authors.forename: C G Toby
authors.initials: CG
authors.lastname: Mathias
authors.forename: Denis
authors.initials: D
authors.lastname: Sasseville
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Zirwas
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fowler
authors.forename: Joel G
authors.initials: JG
authors.lastname: DeKoven
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Fransway
authors.forename: Vincent A
authors.initials: VA
authors.lastname: DeLeo
authors.forename: James G
authors.initials: JG
authors.lastname: Marks
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Pratt
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Storrs
mesh_terms: D000368:Aged; D000485:Allergens / Q000009:adverse effects* / Q000032:analysis; D001577:Benzophenones / Q000009:adverse effects / Q000032:analysis; D003430:Cross-Sectional Studies; D003877:Dermatitis, Contact / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D010328:Patch Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013473:Sunscreening Agents / Q000009:adverse effects* / Q000032:analysis
chemical_list: D000485:Allergens; D001577:Benzophenones; D013473:Sunscreening Agents; C005290:oxybenzone