title: Oxidized limonene and oxidized linalool - concomitant contact allergy to common fragrance terpenes.
abstract: BACKGROUND
  Limonene and linalool are common fragrance terpenes. Both oxidized R-limonene and oxidized linalool have recently been patch tested in an international setting, showing contact allergy in 5.2% and 6.9% of dermatitis patients, respectively.
  
  
  OBJECTIVE
  To investigate concomitant reactions between oxidized R-limonene and oxidized linalool in consecutive dermatitis patients.
  
  
  METHODS
  Oxidized R-limonene 3.0% (containing limonene hydroperoxides 0.33%) and oxidized linalool 6% (linalool hydroperoxides 1%) in petrolatum were tested in 2900 consecutive dermatitis patients in Australia, Denmark, Singapore, Spain, Sweden, and the United Kingdom.
  
  
  RESULTS
  A total of 281 patients reacted to either oxidized R-limonene or oxidized linalool. Of these, 25% had concomitant reactions to both compounds, whereas 29% reacted only to oxidized R-limonene and 46% only to oxidized linalool. Of the 152 patients reacting to oxidized R-limonene, 46% reacted to oxidized linalool, whereas 35% of the 200 patients reacting to oxidized linalool also reacted to oxidized R-limonene.
  
  
  CONCLUSIONS
  The majority of the patients (75%) reacted to only one of the oxidation mixtures, thus supporting the specificity of the reactions. The concomitant reactions to the two fragrance allergens suggest multiple sensitizations, which most likely reflect the exposure to the different fragrance materials in various types of consumer products. This is in accordance with what is generally seen for patch test reactions to fragrance materials.
authors.affiliation: Department of Dermatology, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden.|Dermatochemistry, Department of Chemistry and Molecular Biology, University of Gothenburg, 412 96, Gothenburg, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Bråred Christensson
authors.affiliation: Dermatochemistry, Department of Chemistry and Molecular Biology, University of Gothenburg, 412 96, Gothenburg, Sweden.
authors.forename: Ann-Therese
authors.initials: AT
authors.lastname: Karlberg
authors.affiliation: Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, 5000, Odense, Denmark.
authors.forename: Klaus E
authors.initials: KE
authors.lastname: Andersen
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.affiliation: The National Allergy Research Centre, Department of Dermato-allergology, Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark.
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
authors.affiliation: Department of Dermatology, University Hospital Virgen Macarena, 41007, Seville, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Garcia-Bravo
authors.affiliation: Department of Dermatology, Hospital del Mar, Institut Mar d'Investigacions Médiques, Universitat Autònoma, 08003, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Giménez Arnau
authors.affiliation: National Skin Centre, 308205, Singapore, Singapore.
authors.forename: Chee-Leok
authors.initials: CL
authors.lastname: Goh
authors.affiliation: Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, 3053, Victoria, Australia.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Nixon
authors.affiliation: Department of Cutaneous Allergy, St John's Institute of Dermatology, St Thomas' Hospital, SE1 7EH, London, UK.
authors.forename: Ian R
authors.initials: IR
authors.lastname: White
mesh_terms: D000080462:Acyclic Monoterpenes; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D053138:Cyclohexenes / Q000009:adverse effects*; D003718:Denmark / Q000453:epidemiology; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D000077222:Limonene; D039821:Monoterpenes / Q000009:adverse effects*; D010084:Oxidation-Reduction; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects*; D012846:Singapore / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D013729:Terpenes / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000080462:Acyclic Monoterpenes; D053138:Cyclohexenes; D039821:Monoterpenes; D010476:Perfume; D013729:Terpenes; D000077222:Limonene; C018584:linalool
keywords: allergic contact dermatitis; autoxidation; concomitant reactions; fragrance allergy; hydroperoxides; limonene; linalool; oxidation products; patch test concentration; patch testing