1
|
Sukakul T, Bruze M, Mowitz M, Kiuru A, Svedman C. Allergic Contact Dermatitis to Linalool Hydroperoxides: Pitfalls in the Diagnostic Process-Findings from a Repeated Open Application Test Study. Dermatitis 2024; 35:373-379. [PMID: 38386591 DOI: 10.1089/derm.2023.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Background: Increasing trends of oxidized linalool contact allergy have been reported. However, the impact of reactivity and dose in eliciting allergic contact Dermatitis caused by linalool hydroperoxides is insufficiently investigated. Objectives: To perform repeated open application tests (ROATs) using the real-world concentrations of linalool hydroperoxides in patients and control participants. Materials and Methods: Patients who previously had a positive (patients) and a negative (controls) patch test reaction to linalool hydroperoxides 1.0% in petrolatum were patch tested with a dilution series of linalool hydroperoxides preparations and asked to perform ROAT twice daily with 3 concentrations of linalool hydroperoxides creams and a negative control cream for 28 days. The creams contain 44, 140, and 440 PPM of linalool hydroperoxides, representing real-world doses reported in consumer products. Results: Of all 47 participants, 31 were linalool hydroperoxides contact allergy patients, and 16 were controls. One patient had a positive ROAT reaction in the area where cream at the highest concentration of linalool hydroperoxides was applied for 28 days. Conclusions: Repeated exposure to creams containing linalool hydroperoxides at real-life concentrations could rarely elicit an allergic reaction on intact skin after 4 weeks.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Mowitz
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Anna Kiuru
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- From the Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
2
|
Sukakul T, Uter W, Gonçalo M, Huggard J, Ljubojević Hadžavdić S, Schuttelaar MLA, Svedman C, Vey M, Isaksson M, Niklasson B, Rustemeyer T, Bruze M. Results of patch testing with five fragrance materials hitherto not tested: A dose-finding study in the clinical population. Contact Dermatitis 2024; 90:566-573. [PMID: 38387040 DOI: 10.1111/cod.14525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Quantitative risk assessment (QRA) for skin sensitization is used to derive safe use levels of sensitising fragrance ingredients in products. Post-marketing surveillance of the prevalence of contact allergy to these ingredients provides relevant data to help evaluate the performance of these measures. OBJECTIVES To determine a suitable patch test concentration for five fragrance materials that had hitherto not been tested on a regular basis. These concentrations are then to be used in a surveillance study with patch testing consecutive patients over an extended monitoring period. MATERIALS AND METHODS Furaneol, CAS.3658-77-3; trans-2-hexenal, CAS.6728-26-3; 4,8-dimethyl-4,9-decadienal, CAS.71077-31-1; longifolene, CAS.475-20-7; benzaldehyde, CAS.10052-7, were patch tested with other fragrance allergens in four clinics. Patch testing was conducted in three rounds, starting with the lowest concentrations of the five ingredients. The doses were increased in the subsequent rounds if no late-appearing positive reactions and virtually no irritant reactions were reported. RESULTS Overall, 373 patients were tested. No positive allergic reaction was reported to the five ingredients. Patch test results of other fragrance allergens are reported. CONCLUSIONS The highest test concentrations are each considered safe for patch testing consecutive patients. Further surveillance based on these preparations will evaluate the hypothesis that QRA-driven consumer product levels of these fragrances can prevent sensitization.
Collapse
Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, Erlangen, Germany
| | - Margarida Gonçalo
- Department of Dermatology, Coimbra University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joseph Huggard
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marie L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, Groningen, The Netherlands
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Matthias Vey
- The Huggard Consulting Group, S.A.R.L., Itzig, Luxembourg
- IFRA VP Scientific Affairs and IDEA Management Team, Brussels, Belgium
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| | | | - Thomas Rustemeyer
- Department of Dermatology-Allergology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Faculty of Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
3
|
Schubert S, Geier J, Brans R, Heratizadeh A, Kränke B, Schnuch A, Bauer A, Dickel H, Buhl T, Vieluf D, Wagner N, Worm M. Patch testing hydroperoxides of limonene and linalool in consecutive patients-Results of the IVDK 2018-2020. Contact Dermatitis 2023. [PMID: 37177844 DOI: 10.1111/cod.14332] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Hydroperoxides of limonene (Lim-OOHs) and linalool (Lin-OOHs) are potent contact sensitizers. OBJECTIVES To investigate the prevalence of positive patch test (PT) reactions to Lim-OOHs and Lin-OOHs in consecutive patients, their demographic factors and concomitant reactions. METHODS Between 7/2018 and 12/2020, Lim-OOHs 0.3% pet. and Lin-OOHs 1% pet. were patch tested in 5511 consecutive patients. We assessed PT reactivity and analysed data from patients with either positive or negative PTs to Lim-OOHs and Lin-OOHs. RESULTS Positive PT results to Lim-OOHs (n = 170, 3.1%) and Lin-OOHs (n = 483, 8.8%) were frequent. Most of the positive reactions were weak (LimOOHs n = 134/LinOOHs n = 429), and even more frequently, doubtful (n = 252/n = 578) or irritant reactions (n = 81/n = 178) were documented. PT reactivity to Lim-OOHs and Lin-OOHs was increased in patients with irritant reactions to sodium lauryl sulphate (SLS). The proportion of leg dermatitis and concomitant positive reactions to fragrances and essential oils was increased in patients with reactivity to these hydroperoxides. CONCLUSION The observed reaction pattern suggests that both test preparations display an irritant potential with an increased risk of false positive reactions. Preparations should be chemically monitored in order to reduce irritancy. Mindful interpretation of PT results and aimed patch testing of lower concentrations is recommended.
Collapse
Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine, and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Annice Heratizadeh
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Birger Kränke
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Centre Göttingen, Göttingen, Germany
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, University Medical Center, Ruhr University Bochum, Bochum, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Dieter Vieluf
- Department of Allergology, Photodermatology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany
| | - Nicola Wagner
- Department of Dermatology, Erlangen University Hospital, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
4
|
DeKoven JG, Warshaw EM, Reeder MJ, Atwater AR, Silverberg JI, Belsito DV, Sasseville D, Zug KA, Taylor JS, Pratt MD, Maibach HI, Fowler JF, Adler BL, Houle MC, Mowad CM, Botto N, Yu J, Dunnick CA. North American Contact Dermatitis Group Patch Test Results: 2019-2020. Dermatitis 2023; 34:90-104. [PMID: 36917520 DOI: 10.1089/derm.2022.29017.jdk] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). Objective: This study documents the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2019, to December 31, 2020. Methods: At 13 centers in North America, patients were tested in a standardized manner with a screening series of 80 allergens, and, as indicated, supplemental allergens. Results: Overall, 4121 patients were tested; 2871 (69.7%) had at least 1 positive/allergic patch test reaction and 2095 patients (51.2%) had a primary diagnosis of ACD. The most commonly positive allergens were nickel (18.2%), methylisothiazolinone (MI) (13.8%), fragrance mix (FM) I (12.8%), hydroperoxides of linalool (HPL) (11.1%), and benzisothiazolinone (BIT) (10.4%). Compared with that of 2017-2018, prevalence of top 20 allergens statistically increased for FM I, HPL, BIT, propolis, and hydroperoxides of limonene (3.5%). For the first time, MI positivity did not increase between reporting periods. Approximately one-fifth of patients (20.3%) had ≥1 clinically relevant reaction(s) to allergens/substances not on the NACDG series. Conclusions: The epidemic of MI contact allergy in North America may have reached a plateau. Patch testing using a robust screening series, and supplemental allergens as indicated, is necessary for comprehensive evaluation of ACD.
Collapse
Affiliation(s)
- Joel G DeKoven
- From the *Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Division of Occupational Health, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
| | - Erin M Warshaw
- Department of Dermatology, Park Nicollet/Health Partners Health Services, Minneapolis, Minnesota, USA
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA
| | - Margo J Reeder
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amber R Atwater
- Department of Dermatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Donald V Belsito
- Department of Dermatology, Columbia University Irving Medical College, New York, New York, USA
| | - Denis Sasseville
- Division of Dermatology, McGill University Health Centre, Montréal, Canada
| | - Kathryn A Zug
- Department of Dermatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, Nebraska, USA
| | - James S Taylor
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Melanie D Pratt
- Division of Dermatology, University of Ottawa, Ottawa, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Joseph F Fowler
- Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Brandon L Adler
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Marie-Claude Houle
- Division of Dermatology, Centre Hospitalier Universitaire de Québec, Laval University, Québec, Canada
| | - Christen M Mowad
- Division of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Nina Botto
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado, Aurora, Colorado, USA
| |
Collapse
|