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This review updates contact allergy to propolis, finding Brazilian propolis causes frequent reactions, likely due to fragrance cross-sensitization rather than true propolis allergy.

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Area of Science:

  • Dermatology
  • Allergology
  • Cosmetic Science

Background:

  • Propolis allergy reviews are essential for understanding contact dermatitis.
  • Previous reviews highlighted propolis as a contact allergen.
  • Updated literature is needed due to new propolis sources and testing methods.

Purpose of the Study:

  • To provide an updated review of propolis contact allergy literature from March 2013 to May 2025.
  • To analyze the emergence of Brazilian propolis as a significant patch test allergen.
  • To investigate the causes of frequent positive reactions to Brazilian propolis and assess its role in cosmetic allergy.

Main Methods:

  • Comprehensive literature search on propolis contact allergy.
  • Analysis of patch test results from consecutive and selected patient groups.
  • Review of case reports and series, including co-reactivity studies.
  • Examination of propolis component analyses and cosmetic usage data.

Main Results:

  • Brazilian propolis (Allergeaze) has emerged as a surprising and frequent patch test allergen.
  • High rates of positive reactions to Brazilian propolis may be linked to fragrance cross- or pseudo-cross-reactions.
  • Propolis is infrequently used in cosmetics and is a rare cause of sensitization.
  • Distinguishing between Chinese and Brazilian propolis in testing is crucial.

Conclusions:

  • The high prevalence of positive patch tests to Brazilian propolis warrants further investigation into its allergenic potential and cross-reactivity.
  • Fragrance sensitization is a more probable cause for many positive propolis patch tests than true propolis allergy.
  • Clear identification of propolis source material in studies is critical for accurate interpretation of contact allergy data.