title: Sorbitan sesquioleate; a rare cause of contact allergy in consecutively patch tested dermatitis patients.
abstract: BACKGROUND
  Sorbitan sesquioleate (SSO) has been added to fragrance mix I (FM I) as an emulsifier since the 1990s. Being a contact allergen itself, SSO has the potential to cause false-positive reactions to FM I. Recent results obtained with selected FM I-positive patients have shown that 5% have concomitant positive reactions to SSO.
  
  
  OBJECTIVE
  To investigate the 5-year prevalence of contact allergy to SSO and evaluate the importance of SSO allergy when patch test results for FM I are interpreted.
  
  
  METHODS
  This was a retrospective database study of consecutively patch tested eczema patients (n = 4,637) from 2010 to 2014. All patients were tested with our baseline series including FM I and SSO 20% in pet.
  
  
  RESULTS
  Sensitization to SSO was identified in 9 (0.2%) patients. The proportion of FM I-positive patients with concomitant positive reactions to SSO was 1.4%.
  
  
  CONCLUSIONS
  SSO is a rare cause of contact allergy, with a 5-year prevalence of 0.2% in consecutively tested patients. Contact allergy to the emulsifier does not play a major role when the overall frequency of contact allergy to FM I is evaluated. However, to correctly diagnose individual patients, concomitant patch testing with FM I and SSO is encouraged.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Niels Højsager
authors.initials: NH
authors.lastname: Bennike
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Jeanne Duus
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects*; D016208:Databases, Factual; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D045703:Emulsifying Agents / Q000009:adverse effects*; D005189:False Positive Reactions; D005260:Female; D006601:Hexoses / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D000485:Allergens; D045703:Emulsifying Agents; D006601:Hexoses; D010476:Perfume; C058854:sorbitan sesquioleate
keywords: clinical relevance; concomitant reactions; contact allergy; emulsifier; fragrance mix I; fragrances; sorbitan sesquioleate