A negative breakdown test in a fragrance mix I‐positive patient does not rule out contact allergy to its fragrance constituents. (1st March 2021)

• Record Type: Journal Article
• Authors: Geier, Johannes; Schubert, Steffen; Schnuch, Axel; Szliska, Christiane; Weisshaar, Elke; Kränke, Birger; Werfel, Thomas; Ruëff, Franziska; Schröder‐Kraft, Claudia; Buhl, Timo
• Other Names: Baron Jens Malte investigator.; Grabbe Jürgen investigator.; Siedlecki Katharina investigator.; Strom Kerstin investigator.; Hofmeier Kathrin Scherer investigator.; Worm Margitta investigator.; Simon Dagmar investigator.; Effendy Isaak investigator.; Dickel Heinrich investigator.; Fartasch Manigé investigator.; Vieluf Dieter investigator.; Beiteke Ulrike investigator.; Bauer Andrea investigator.; Koch André investigator.; Wagner Nicola investigator.; Dissemond Joachim investigator.; Gina Michal investigator.; Grunwald‐Delitz Heidrun investigator.; Jünger Michael investigator.; Kreft Burkhard investigator.; Witte Jana investigator.; Schäkel Knut investigator.; Löffler Harald investigator.; Pföhler Claudia investigator.; Schliemann Sibylle investigator.; Heine Guido investigator.; Spring Philipp investigator.; Treudler Regina investigator.; Nestoris Stefan investigator.; Recke Andreas investigator.; Becker Detlef investigator.; Schmieder Astrid investigator.; Pfützner Wolfgang investigator.; Stadler Rudolf investigator.; Coras‐Stepanek Brigitte investigator.; Brockow Knut investigator.; Brehler Randolf investigator.; Baur Vera investigator.; Raap Ulrike investigator.; Skudlik Christoph investigator.; Prager Welf investigator.; Emmert Steffen investigator.; Rieker‐Schwienbacher Juliane investigator.; Wilfinger Daniel investigator.; Forchhammer Stephan investigator.; Weiß Johannes investigator.; Trautmann Axel investigator.; Mechtel Dirk investigator.; Lang Claudia investigator.;
• Is Part Of: Contact dermatitis. Volume 84:Number 6(2021)
• Page Start: 407
• Page End: 418
• Publication Date: 2021-03-01
• Subjects: amyl cinnamal -- breakdown test -- clinical epidemiology -- eugenol -- fragrance allergy -- fragrance mix I -- geraniol -- patch test concentration -- patch testing; Contact dermatitis -- Periodicals; 616.51
• DOI: 10.1111/cod.13803
• Languages: English
• ISSNs: 0105-1873

Abstract

Abstract: Background: In about half of the patients reacting positive to fragrance mix I (FM I), breakdown testing remains negative. This raises the question of whether the reaction to FM I is false‐positive, or the breakdown test is false‐negative. Objectives: To identify characteristics and sensitization patterns of patients positive to FM I, but not to its fragrance constituents. Patients and Methods: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK) between 2005 and 2019. Three patient groups were defined according to their reaction pattern: Group I, FM I positive and ≥1 single fragrance positive in the breakdown test (n = 1912); Group II, FM I positive and breakdown test negative (n = 1318); Group III, FM I negative (n = 19 790). Results: Regarding the pattern of concomitant reactions to other fragrances, Group II had an intermediate position between Group I and Group III. In other respects (age and sex distribution, frequency of sensitization to non‐fragrance baseline series allergens), Group II rather resembled Group I. Conclusions: Not every positive reaction to FM I in patients with negative breakdown tests is false‐positive. There may be false‐negative reactions to the single fragrance components when patch tested at 1% pet. Raising patch concentrations of some single fragrances is recommended.