Patch testing with the European baseline series fragrance markers: A 2016 update

Summary

Background

Fragrance contact allergy is common and is currently screened for with the European baseline series fragrance markers: Fragrance Mix 1, Fragrance Mix 2, Myroxylon pereirae and hydroxyisohexyl 3-cyclohexene carboxaldehyde.

Objectives

To investigate the validity of patch testing with these fragrance markers in detecting fragrance allergy to 26 individual fragrance substances for which cosmetic ingredient labelling is mandatory in the European Union.

Methods

We conducted a retrospective review of the patch test records of all eczema patients who underwent testing with the European baseline series extended with the individual fragrance substances during the period 2015-2016.

Results

359 patients (17.2%) reacted to one or more allergens from the labelled fragrance substance series and/or a fragrance marker from the European baseline series. The allergens that were positive with the greatest frequencies were oxidised linalool (154; 7.4%, 95% CI 6.3%-8.6%), oxidised limonene (89; 4.3%, 95% CI 3.4%-5.2%) and Evernia furfuracea (44; 2.1%, 95% CI 1.5%-2.8%). Of the 319 patients who reacted to any of the labelled fragrance substances, only 130 (40.8%) also reacted to a baseline series fragrance marker. The sensitivity of our history-taking for fragrance allergy was 25.7%.

Conclusions

With the evolving trends in fragrance allergy patch testing with Fragrance Mix 1, Fragrance Mix 2, Myroxylon pereirae and hydroxyisohexyl 3-cyclohexene carboxaldehyde are no longer sufficient for screening for fragrance allergy.

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