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Journal of the American Academy of Dermatology
Volume 63, n° 5
pages 789-798 (novembre 2010)
Doi : 10.1016/j.jaad.2009.11.033
accepted : 1 November 2009
Original Articles

Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007
 

David A. Wetter, MD a, James A. Yiannias, MD c, , Amy V. Prakash, MD a, Mark D.P. Davis, MD a, Sara A. Farmer, BA b, Rokea A. el-Azhary, MD a
a Department of Dermatology, Mayo Clinic, Rochester, Minnesota 
b Division of Biomedical Informatics and Biostatistics, Mayo Clinic, Rochester, Minnesota 
c Department of Dermatology, Mayo Clinic, Scottsdale, Arizona 

Reprint requests: James A. Yiannias, MD, Department of Dermatology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259.
Abstract
Background

Patch testing to a standard screening series of allergens in combination with supplemental cosmetic allergens is often used to diagnose allergic contact dermatitis due to personal care products.

Objective

To report results of patch testing to skin care product allergens contained in a standard series and a supplemental cosmetic series and to compare efficacy of this combined series in detecting positive reactions to personal care product allergens with the efficacy of various standard screening series.

Methods

Positive reaction rates to skin care product allergens were tabulated for patients who underwent patch testing to both standard and cosmetic series allergens at Mayo Clinic between 2000 and 2007. Data were compared with skin care allergens detected on standard screening series, including the thin-layer rapid use epicutaneous (TRUE) test.

Results

Of 945 patch-tested patients, 68.4% had at least one positive reaction and 47.3% had at least two positive reactions. Also, 49.4% of patients reacted to at least one preservative; 31.2% reacted to at least one fragrance/botanical additive. Compared with use of our standard series and cosmetic series, use of the TRUE test would have missed 22.5% of patients with preservative allergy, 11.3% with fragrance/botanical allergy, and 17.3% with vehicle allergy.

Limitations

Various allergens tested over time, patch test reading by residents, and lack of confirmation of allergen in personal care products.

Conclusion

Standard patch-test screening series miss a substantial number of patients with skin care product ingredient allergy.

The full text of this article is available in PDF format.

Key words : allergens, contact dermatitis, cosmetics, patch tests, skin care

Abbreviations used : FDA, NACDG, TRUE



 Funding sources: None.
 Conflicts of interest: None declared.



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