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Contact Dermatitis. 2019 Apr;80(4):208-216. doi: 10.1111/cod.13168. Epub 2018 Dec 12.

Allergic contact dermatitis caused by hydroperoxides of limonene and dose-response relationship-A repeated open application test (ROAT) study.

Author information

1
National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
2
Department of Occupational Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
3
Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
4
Department of Chemistry and Molecular Biology, Dermatochemistry and Skin Allergy, University of Gothenburg, Gothenburg, Sweden.
5
Department of Analytical Chemistry and Environmental Science, Stockholm University, Stockholm, Sweden.
6
Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.

Abstract

BACKGROUND:

Contact allergy to oxidized limonene, with hydroperoxides of limonene (Lim-OOHs) as the main allergens, is common. However, high proportions of weak positive and doubtful patch test reactions have been reported.

OBJECTIVES:

To determine the clinical relevance, elicitation threshold and dose-response relationship of Lim-OOHs in individuals with a positive or doubtful patch test reaction to standard Lim-OOHs 0.3% pet.

METHODS:

A multicentre 3-week double-blind vehicle-controlled repeated open application test (ROAT) study with a simulated fine fragrance containing Lim-OOHs at 1260, 420 and 140 ppm, equal to a dose/area per application of Lim-OOHs of 3.0, 0.99 and 0.33 μg/cm2 , was performed.

RESULTS:

Among 11 subjects allergic to Lim-OOHs, 11 (100%), 7 (64%), and 3 (27%), respectively, reacted to the applied doses. No reactions were seen in 17 healthy controls exposed to the highest dose. This difference in reactivity was statistically significant (P < 0.0001). Among 13 subjects with doubtful patch test reactions to Lim-OOHs, two (15%) had positive ROAT reactions to the highest Lim-OOH dose applied (P = 0.36 as compared with controls).

CONCLUSIONS:

Contact allergy to Lim-OOHs is of clinical relevance in patients with positive patch test reactions. A doubtful patch test reaction to Lim-OOHs 0.3% pet. can be of clinical relevance.

KEYWORDS:

ROAT; allergic contact dermatitis; clinical relevance; contact allergy; dose-response relationship; fragrance substance; limonene hydroperoxides; oxidized limonene

PMID:
30378136
DOI:
10.1111/cod.13168
[Indexed for MEDLINE]

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