Atopic dermatitis (eczema)

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Frequency of allergic contact dermatitis to isoeugenol is increasing: a review of 3636 patients tested from 2001 to 2005.

Br J Dermatol. 2007 Sep;157(3):580-2

Authors: White JM, White IR, Glendinning A, Fleming J, Jefferies D, Basketter DA, McFadden JP, Buckley DA

BACKGROUND: Isoeugenol is an important fragrance allergen. The cosmetic industry was recommended voluntarily to reduce concentrations of isoeugenol in finished cosmetic products from 0.2% to 0.02% in 1998. It was suspected that this would reduce the incidence of patch test positivity in individuals undergoing routine patch testing after approximately 2-3 years (the Dillarstone effect). OBJECTIVES: To review our patch test data since the change in practice by industry, to see if there has been an observable decrease in isoeugenol contact sensitivity. METHODS: We retrospectively analysed all subjects patch tested to isoeugenol 1% pet. in the St John's Department of Cutaneous Allergy over a period of 5 years, commencing 3 years after the changes. RESULTS: We identified 3636 subjects, 97 of whom were positive for isoeugenol. Year-on-year incidence shows an increasing trend, with an overall incidence of 2.67%. Using the exact Cochran-Armitage test, this ascending trend is statistically significant (P = 0.0182). Seventy-two of 97 isoeugenol-positive subjects were also positive to fragrance mix I. Other fragrances positive in these 97 patients included Myroxylon pereirae (30%), Evernia prunastri (22%) and eugenol (15%). CONCLUSIONS: We suspect that the increasing trend may be due to allergen substitution with compounds chemically related to isoeugenol, or which hydrolyse to isoeugenol itself.

PMID: 17573874 [PubMed - indexed for MEDLINE]