Allergia da contatto ai componenti di una "serie integrativa profumi" in pazienti con dermatite eczematosa

Introduction: fragrances are a frequent cause of allergic contact dermatitis (ACD). Fragrance mix (FM) is used to screen fragrance allergy. It allows us to identify the 70-80% of patients allergic to fragrances, but the eight individual essences contained in this mixture are not able to identify allergies to the hundreds of fragrances, natural or synthetic, contained in perfumes or sweet-smelling products. Objective: the aim of this study is to evaluate the frequency of allergic reactions to some fragrances that are not included in FM, but that are reported in the literature as being responsible for ACD, by considering their concurrence with the reactions to FM. Materials and methods: 292 patients with eczematous dermatitis were studied. They showed intolerance to fragrances and/or eczematous lesions on the neck, the wrist and the face, regions typically affected by ACD from fragrances. The patients were patch tested with the SIDAPA standard series that contains FM and balsam of Perù (BP), and with an "integrative fragrances series" that contains 14 essences tested in petrolatum. Results: reactions to FM and/or BP occurred in 195 out of 292 subjects, while 116 patients, 24 of which were negative to FM and/or BP, showed a positive reaction to one or more essences of the "integrative fragrances series". The most frequent positive reactions were to ylang-ylang oil, followed by lyral, pure narcissus oil, alfahexyl-cinnamic aldehyde, pure jasmine, farnesol, and citral. Conclusions: our study confirms that a negative reaction to FM cannot exclude a sensitization to fragrances. It was shown that in the patients with an intolerance to fragrances, it is important to also test for ylang-ylang oil, lyral and pure narcissus oil in addition to the eight individual essences contained in FM.