Contact allergy to oxidized d-limonene among dermatitis patients.

d-Limonene, obtained as a by-product from the citrus juice industry, was introduced on the market as a more environmentally friendly defatting and cleaning agent than the traditionally used organic solvents. Autoxidation of d-limonene readily occurs to give a variety of oxygenated monocyclic terpenes that are strong contact allergens. The aim of the present study was to investigate the prevalence of contact allergy to air exposed d-limonene among dermatitis patients. A fraction consisting of d-limonene hydroperoxides was also tested. Screening with oxidized d-limonene will detect cases of allergic contact dermatitis. Additional cases were detected when testing with the fraction of limonene hydroperoxides. The proportion of positive patch test reactions to oxidized d-limonene was comparable to that seen for several of the allergens within the standard series. An increased use of d-limonene containing allergenic oxidation products in industry where high concentrations are used, as well as in domestic exposure, might result in contact sensitization and dermatitis. Patients reacting to d-limonene often reacted to fragrance mix, balsam of Peru and colophony in the standard series.