Document Detail

Atopic dermatitis and allergic reactions to individual fragrance chemicals.
MedLine Citation:
PMID:  19178409     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Allergic contact dermatitis prevalence is reported as equal in atopic and nonatopic dermatitis. Atopic dermatitis is under-represented in those with allergic contact dermatitis to agents having cutaneous and dietary exposure. We compared rates of atopic dermatitis between patients with allergic contact dermatitis arising out of individual fragrance chemicals with known oral/cutaneous exposure against exclusively cutaneous exposure. METHODS: Between 1982 and 2007, 37 065 dermatitis patients were tested with Fragrance mix I. Those who were positive were tested for individual fragrance allergy. Chemicals were categorized according to whether their exposure pattern was solely cutaneous, oral or mixed. Current and past atopic dermatitis rates were compared between the whole population and groups allergic to individual fragrances. Age and gender were controlled. RESULTS: Cinnamic alcohol and cinnamal allergy groups had reduced rates of both 'current' [24/266 (9.0%) P = 0.0008, 38/364 (10.4%) P = 0.0005] and 'past' atopic dermatitis [44/266 (16.5%) P = 0.009, 70/346 (19.2%) P = 0.037]. Atopic dermatitis rates in groups allergic to Evernia prunastri and hydroxycitronellal (cutaneous exposure only) were not reduced [120/597 (20.1%) and 41/153 (26.8%)]. Groups allergic to cinnamic alcohol (P < 0.0001, P < 0.0001) and cinnamal (P < 0.0001, P < 0.004) had reductions in 'current' and 'past' atopic dermatitis, compared with Evernia prunastri. CONCLUSIONS: Patients allergic to individual fragrances with dietary exposure have reduced rates of atopic dermatitis. This suggests that patients with atopic dermatitis have heightened oral tolerance to dietary haptens, in contrast to the known close association of atopic dermatitis with food-protein allergy. Haptens may interfere with food protein tolerance by binding to soluble protein to alter its configuration and immunogenic profile.
J M L White; I R White; I Kimber; D A Basketter; D A Buckley; J P McFadden
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Allergy     Volume:  64     ISSN:  1398-9995     ISO Abbreviation:  Allergy     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-30     Completed Date:  2009-04-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7804028     Medline TA:  Allergy     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  312-6     Citation Subset:  IM    
Department of Cutaneous Allergy, St John's Institute of Dermatology, St Thomas' Hospital, London.
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MeSH Terms
Allergens / immunology
Dermatitis, Allergic Contact / complications,  etiology*
Dermatitis, Atopic / complications,  epidemiology*
Haptens / immunology
Middle Aged
Perfume / adverse effects*,  chemistry
Retrospective Studies
Reg. No./Substance:
0/Allergens; 0/Haptens; 0/Perfume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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