Patch testing with fine fragrances: comparison with fragrance mix, balsam of Peru and a fragrance series

Abstract

High frequencies of contact allergy to fragrance ingredients have been reported in recent years. Only approximately 70-80% are detected by fragrance allergens in the standard patch test series. This investigation compares the patch test reactions to fine fragrances with reactions to fragrance mix (FM), balsam of Peru (BP) (Myroxylon pereirae resin) and a fragrance series. 641 consecutive patients with eczema were patch tested with the European standard series and with selected fine fragrances. Those who were positive to 1 of the fine fragrances or the FM or BP were also tested with the fragrance series. 95 (14.8%) patients were found to have a positive patch test reaction to FM or BP; 41 (6.4%) had positive results to fragrance no. 1 and 29 (4.5%) to no. 2. 9 (9.5% of the 95 positive patients) had a positive reaction to fine fragrances and a negative reaction to all other fragrance allergens in the standard series. These findings indicate that testing with fine fragrances can add to our evaluation of fragrance-sensitive patients.