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Patch testing with the European baseline series fragrance markers: a 2016 update
C Y Ung1, J M L White1, I R White1
1Guy's and St Thomas' University Hospital, St John's Institute of Dermatology, London, U.K.
Current fragrance allergy screening using European baseline markers is insufficient. Patch testing with individual fragrance substances reveals higher allergen frequencies, indicating a need for updated screening protocols to accurately detect fragrance contact allergy.
Area of Science:
- Dermatology
- Allergology
- Cosmetic Science
Background:
- Fragrance contact allergy is a prevalent condition.
- Current screening relies on European baseline series fragrance markers: fragrance mix (FM)I, FMII, Myroxylon pereirae, and hydroxyisohexyl 3-cyclohexene carboxaldehyde.
Purpose of the Study:
- To evaluate the diagnostic accuracy of existing fragrance markers in identifying allergies to 26 individual fragrance substances mandated for cosmetic labeling in the EU.
- To assess the effectiveness of current patch testing protocols for fragrance allergy.
Main Methods:
- Retrospective analysis of patch test records from eczema patients tested between 2015 and 2016.
- Inclusion of European baseline series alongside extended individual fragrance substances for testing.
Main Results:
- 359 patients (17.2%) showed positive reactions to labelled fragrance substances or baseline markers.
- Highest reaction frequencies observed for oxidized linalool (7.4%), oxidized limonene (4.3%), and Evernia furfuracea (2.1%).
- Only 40.8% of patients reacting to labelled substances also reacted to a baseline marker; history-taking sensitivity was 25.7%.
Conclusions:
- The established European baseline fragrance markers (FMI, FMII, M. pereirae, hydroxyisohexyl 3-cyclohexene carboxaldehyde) are inadequate for current fragrance allergy screening.
- Evolving trends in fragrance allergy necessitate updated patch testing strategies for accurate diagnosis.
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