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Related Experiment Videos

Simultaneous sensitivity to fragrances.

D A Buckley1, D A Basketter, C K Smith Pease

  • 1Contact Dermatitis Clinic, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, UK. dbuckley@doctors.org.uk

The British Journal of Dermatology
|April 26, 2006
PubMed
Summary

Simultaneous sensitization to cinnamal/cinnamic alcohol and isoeugenol/eugenol is common in patients with suspected fragrance allergy. All four fragrance chemicals should remain separate in Fragrance Mix I testing to avoid missed diagnoses.

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Area of Science:

  • Dermatology
  • Allergology
  • Chemical Sensitization

Background:

  • Fragrance Mix I (FM I) contains cinnamal/cinnamic alcohol and isoeugenol/eugenol, structurally similar fragrance chemicals.
  • Simultaneous sensitivity to these pairs is hypothesized but lacks robust data.

Purpose of the Study:

  • Determine the frequency of simultaneous reactions to cinnamal, cinnamic alcohol, isoeugenol, and eugenol.
  • Provide evidence for proposed metabolic pathways of these fragrance allergens.
  • Assess the necessity of including all four constituents separately in FM I for accurate diagnosis.

Main Methods:

  • Retrospective analysis of patient records patch tested to the European standard series (1984-1998).
  • Identified positive reactions to FM I and its constituents: cinnamal, cinnamic alcohol, isoeugenol, and eugenol.

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  • Statistical analysis using 2x2 contingency tables and Fisher's exact test.

    • Main Results:

    • Out of 23,660 patients, 7.7% reacted to FM I. Of 1112 tested to constituents, 934 had positive reactions.
    • 87/139 (63%) allergic to cinnamic alcohol also reacted to cinnamal (P<0.00001).
    • 50/231 (22%) allergic to isoeugenol also reacted to eugenol (P=0.0002).

    Conclusions:

    • Data support a common hapten for cinnamal and cinnamic alcohol, and limited simultaneous sensitization to isoeugenol and eugenol.
    • Despite different metabolic pathways, co-sensitization occurs.
    • All four fragrance chemicals are essential as separate FM I constituents to prevent missed diagnoses.