Erin M Warshaw, Rob L Shaver, Joel G DeKoven1, Howard I Maibach2, James S Taylor3, Amber R Atwater4, Donald V Belsito5, Jonathan I Silverberg6, Margo J Reeder7, Kathryn A Zug8, Denis Sasseville9, Joseph F Fowler10, Melanie D Pratt11, Anthony F Fransway12, Vincent A DeLeo13. 1. Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada. 2. Department of Dermatology, University of California San Francisco. 3. Department of Dermatology, Cleveland Clinic, OH. 4. Department of Dermatology, Duke University Medical Center, Durham, NC. 5. Department of Dermatology, Columbia University Irving Medical School, New York, NY. 6. Department of Dermatology, The George Washington University School of Medicine and Health Sciences, DC. 7. Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison. 8. Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH. 9. Division of Dermatology, Montreal General Hospital, McGill University, Quebec, Canada. 10. Division of Dermatology, University of Louisville, KY. 11. Division of Dermatology, University of Ottawa, Ontario, Canada. 12. Associates in Dermatology, Fort Myers, FL. 13. Department of Dermatology, Keck School of Medicine, Los Angeles, CA.
Abstract
BACKGROUND/ OBJECTIVES: Carvone, a flavoring agent, may cause allergic contact dermatitis. This study summarizes patch test reactions to carvone in patients tested by the North American Contact Dermatitis Group, 2009 to 2018. METHODS: This was a retrospective analysis of patients positive to carvone (5% petrolatum). Demographics were compared with those of patients who were negative. Other analyses included reaction strength, clinical relevance, coreactivity with other fragrance/flavor allergens, and exposure sources. RESULTS: Of 24,124 patients tested to carvone, 188 (0.78%) were positive. As compared with carvone-negative patients, carvone-positive patients were significantly more likely older than 40 years (P = 0.0284). Women (76.1%) and/or facial involvement (33.0%) were common in the carvone-positive group but not statistically different from carvone-negative patients; 73.3% (n = 138) of the reactions were currently relevant. Relevant sources were personal care products (46.3%, n = 87) and food (14.3%, n = 27). Coreactivity with other fragrance/flavor markers was present in 60.6% of carvone-positive patients, most commonly fragrance mix I (34.6%), balsam of Peru (24.5%), and cinnamic aldehyde (15.4%). CONCLUSIONS: Ten-year prevalence of carvone sensitivity was 0.78%. Most carvone-positive patients were female, were older than 40 years, and/or had facial dermatitis. Personal care products were the most common source. Two-fifths of carvone reactions would have been missed by relying on other fragrance/flavoring allergens.
BACKGROUND/ OBJECTIVES: Carvone, a flavoring agent, may cause allergic contact dermatitis. This study summarizes patch test reactions to carvone in patients tested by the North American Contact Dermatitis Group, 2009 to 2018. METHODS: This was a retrospective analysis of patients positive to carvone (5% petrolatum). Demographics were compared with those of patients who were negative. Other analyses included reaction strength, clinical relevance, coreactivity with other fragrance/flavor allergens, and exposure sources. RESULTS: Of 24,124 patients tested to carvone, 188 (0.78%) were positive. As compared with carvone-negative patients, carvone-positive patients were significantly more likely older than 40 years (P = 0.0284). Women (76.1%) and/or facial involvement (33.0%) were common in the carvone-positive group but not statistically different from carvone-negative patients; 73.3% (n = 138) of the reactions were currently relevant. Relevant sources were personal care products (46.3%, n = 87) and food (14.3%, n = 27). Coreactivity with other fragrance/flavor markers was present in 60.6% of carvone-positive patients, most commonly fragrance mix I (34.6%), balsam of Peru (24.5%), and cinnamic aldehyde (15.4%). CONCLUSIONS: Ten-year prevalence of carvone sensitivity was 0.78%. Most carvone-positive patients were female, were older than 40 years, and/or had facial dermatitis. Personal care products were the most common source. Two-fifths of carvone reactions would have been missed by relying on other fragrance/flavoring allergens.