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Evaluating Copositivity Patterns in Fragrance/Botanical Patch Testing through Hierarchical Clustering and Network

Yul W Yang¹, James A Yiannias¹, Mark D P Davis²

¹From the *Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA.

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|June 18, 2025

Summary

This summary is machine-generated.

Patients allergic to fragrances or botanicals may not need to avoid all such products. This study identified specific fragrance and botanical allergen subgroups, suggesting targeted avoidance is possible.

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Area of Science:

Dermatology
Allergology
Contact Dermatitis

Background:

Fragrances and botanicals are common causes of allergic reactions.
Patients with allergies to one fragrance/botanical are often sensitive to others, leading to broad avoidance recommendations.
Broad avoidance may not always be necessary.

Purpose of the Study:

To investigate patterns of co-positivity in fragrance and botanical patch testing.
To identify distinct subgroups of fragrance and botanical allergens based on cross-reactivity.

Main Methods:

Analysis of pairwise co-positivity rates for 43 fragrance/botanical allergens from 1997-2022.
Utilized background correction, unsupervised hierarchical clustering, and network analysis on patch test data.
Examined 4706 positive reactions from 252,485 patches applied to 15,864 patients.

Main Results:

Hierarchical clustering revealed distinct co-positivity subgroups, including Fragrance Mix I with Myroxylon pereirae, Compositae Mix with sesquiterpene lactone, and others like menthol/Mentha piperita.
Network analysis identified additional intergroup co-positivity reactions.
Specific allergen groupings were identified, such as lichen acid mix/treemoss extract and narcissus/dandelion.

Conclusions:

Fragrance and botanical allergens can be categorized into multiple co-positivity subgroups.
These findings support more targeted avoidance strategies for patients with fragrance/botanical allergies.
Patch testing data, when analyzed with clustering and network analysis, can refine clinical recommendations.