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Contact Dermatitis. 2010 Oct;63(4):187-91. doi: 10.1111/j.1600-0536.2010.01712.x.

Relationship between formaldehyde and quaternium-15 contact allergy. Influence of strength of patch test reactions.

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Department of Dermatology, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.



In groups of patients with formaldehyde allergy, many have positive patch tests to quaternium-15. Conversely, of patients allergic to quaternium-15, over half also react to formaldehyde.


To test our hypothesis that patients with stronger patch test reactions to formaldehyde are more likely to react to quaternium-15, attesting to the aetiological role for formaldehyde in such co-reactivity.


Retrospective analysis of all patients patch tested with formaldehyde and quaternium-15 in the European baseline series between 1994 and 2009 (TRUE test).


In a group of 86 patients allergic to formaldehyde, 73% co-reacted to quaternium-15; in the subgroup of 70 women, the percentage was 83. In both groups, more reactions were observed to quaternium-15 in the patients with a ++ reaction compared to the patients with a + reaction to formaldehyde. Conversely, stronger reactions to quaternium-15 were significantly more often associated with formaldehyde sensitivity in a group of 107 patients reacting to quaternium-15 and a subgroup of 88 women. In men, such effects were not observed and only 5 of 16 (31%) men allergic to formaldehyde also reacted to quaternium-15.


In women, but not in men, stronger reactions to formaldehyde lead to more positive quaternium-15 patch tests.

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