Johannes Geier1, Axel Schnuch1, Holger Lessmann1, Wolfgang Uter2. 1. Information Network of Departments of Dermatology, Georg-August University, 37075, Göttingen, Germany. 2. Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen/Nürnberg, 91054, Erlangen, Germany.
Abstract
BACKGROUND: Fragrance mix I (FM I) and its single constituents contain 5% and 1% sorbitan sesquioleate (SSO), respectively. SSO is a rare sensitizer and a potential irritant. OBJECTIVES: To determine whether the outcome of the FM I breakdown test is affected by positive patch test reactivity to SSO. METHODS: A retrospective analysis of data from the Information Network of Departments of Dermatology, 1998-2013, was performed. RESULTS: The full FM I breakdown test including SSO was tested in 2952 patients. Of these, 154 (5.2%) had a positive patch test reaction to SSO 20% pet. and 2709 (91.8%) had a negative patch test reaction. Positive reactions to one or more of the single fragrances contained in the mix were significantly more common (82.5% versus 57.3%) in SSO-positive patients, who also had more multiple reactions than FM I-positive patients with negative SSO reactions (61.5% versus 21.3% patients with reactions to two or more fragrances). CONCLUSIONS: Our results indicate that reactivity to SSO markedly affects the outcome of patch testing with FM I and its single constituents. SSO must be an obligatory part of the full FM I breakdown test, and should ideally be included in the baseline series.
BACKGROUND: Fragrance mix I (FM I) and its single constituents contain 5% and 1% sorbitan sesquioleate (SSO), respectively. SSO is a rare sensitizer and a potential irritant. OBJECTIVES: To determine whether the outcome of the FM I breakdown test is affected by positive patch test reactivity to SSO. METHODS: A retrospective analysis of data from the Information Network of Departments of Dermatology, 1998-2013, was performed. RESULTS: The full FM I breakdown test including SSO was tested in 2952 patients. Of these, 154 (5.2%) had a positive patch test reaction to SSO 20% pet. and 2709 (91.8%) had a negative patch test reaction. Positive reactions to one or more of the single fragrances contained in the mix were significantly more common (82.5% versus 57.3%) in SSO-positive patients, who also had more multiple reactions than FM I-positive patients with negative SSO reactions (61.5% versus 21.3% patients with reactions to two or more fragrances). CONCLUSIONS: Our results indicate that reactivity to SSO markedly affects the outcome of patch testing with FM I and its single constituents. SSO must be an obligatory part of the full FM I breakdown test, and should ideally be included in the baseline series.