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Compound tincture of benzoin: a common contact allergen?

Laura Scardamaglia1, Rosemary Nixon, John Fewings

  • 1Contact Dermatitis Clinic, Skin and Cancer Foundation, Melbourne, Victoria, Australia.

Insights

Compound tincture of benzoin caused allergic reactions in 45 of 477 patients, making it a common allergen. Many reactions were linked to cross-allergies with fragrances and natural resins.

Area of Science:

  • Dermatology
  • Allergology
  • Contact Dermatitis

Background:

  • Compound tincture of benzoin is used in dermatology, but reported cases of contact allergy are rare.
  • Previous literature indicates fewer than 30 cases of allergy to compound tincture of benzoin, with none reported in the last decade.

Purpose of the Study:

  • To present the results of patch testing with compound tincture of benzoin in a patient cohort.
  • To investigate the frequency and potential causes of positive reactions to compound tincture of benzoin.

Main Methods:

  • Patch testing was conducted on 477 patients at the Contact Dermatitis Clinic, Skin and Cancer Foundation, Melbourne.
  • Patients were tested with compound tincture of benzoin, and reactions were recorded.
  • Cross-reactions to fragrance mix, balsam of Peru, colophony, and tea tree oil were assessed.

Main Results:

  • A significant number of patients (45/477) showed a positive reaction to compound tincture of benzoin, identifying it as the third most common allergen in the study.
  • Fourteen patients had strong positive reactions; only two recalled relevant exposure.
  • Twenty-eight patients exhibited cross-reactions to similar allergens, with 11 of 14 strongly reacting patients showing at least one cross-reaction.

Conclusions:

  • Compound tincture of benzoin is a more frequent contact allergen than previously reported.
  • Cross-reactivity with other allergens, particularly fragrances and natural resins, may contribute to the high observed frequency of reactions.
  • Further investigation into cross-reactivity patterns is warranted to understand benzoin allergy.

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