Fragrance- and Botanical-Related Allergy and Associated Concomitant Reactions: A Retrospective Analysis of the North American Contact Dermatitis Group Data 2007-2016.

Journal Article (Journal Article)

IMPORTANCE: When fragrance- and botanical-related (F/BR) allergy is identified, concomitant reaction (CR) frequencies can help direct avoidance recommendations. OBJECTIVE: This study aimed to determine the CR rates for F/BR allergens. DESIGN: A retrospective cross-sectional analysis of the North American Contact Dermatitis Group data 2007-2016 was conducted. Frequencies of demographics, positive reactions, strength of reactions, trends, and CR rates were calculated. RESULTS: A total of 5504 (22.7%) of 24,246 patients had F/BR allergic reactions. The F/BR-sensitive patients were more likely to be female, older than age 40 years, and White and have face, leg, or anal/genital dermatitis. Top allergens included fragrance mix I (FMI, 10.6%), Myroxylon pereirae (balsam of Peru [BOP], 8%), and fragrance mix II (FMII, 4.9%). There were increasing trends for FMI, FMII, cinnamic aldehyde, and Compositae mix and decreasing trends for BOP and propolis. When patients were positive to any F/BR allergen, they were likely to be positive to FMI, FMII, and BOP. Concomitant reactions were bidirectional between multiple fragrance allergens and propolis, colophony, and Compositae mix. CONCLUSIONS: Concomitant reactions were identified between fragrances, between fragrances and BR allergens, and between BR allergens and fragrances. If CRs of greater than 10% suggest cross-reactivity, then all patients with fragrance sensitivity should avoid BR allergens and vice versa.

Full Text

Duke Authors

Cited Authors

  • Atwater, AR; Ward, JM; Liu, B; Green, CL; Belsito, DV; Sasseville, D; DeKoven, JG; Reeder, MJ; Taylor, JS; Maibach, HI; Silverberg, JI; Zug, KA; Fowler, JF; Pratt, MD; DeLeo, VA; Warshaw, EM

Published Date

  • January 2021

Published In

Volume / Issue

  • 32 / 1

Start / End Page

  • 42 - 52

PubMed ID

  • 33273222

Electronic International Standard Serial Number (EISSN)

  • 2162-5220

Digital Object Identifier (DOI)

  • 10.1097/DER.0000000000000661


  • eng

Conference Location

  • United States