Fragrance mix I and II: Results of breakdown tests

Abstract

Since the late 1970s, a fragrance mix (FM I) consisting of amyl cinnamal, cinnamal, cinnamyl alcohol, eugenol, geraniol, hydroxycitronellal, isoeugenol and oakmoss absolute (Evernia prunastri) has been used as a screening agent for contact allergy to fragrances in the baseline patch test series. In 2005, another mix (FM II) was added, consisting of citronellol, coumarin, farnesol, hexyl cinnamal and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC). Leading allergens are oakmoss absolute and isoeugenol in FM I, and HICC in FM II. The aim of the present study was analyse, if the internal ranking of fragrance allergens has changed in the course of the years, and to analyse cross reactivity between selected fragrance compounds. Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 1998-2013 (FM I), and 2005-2013 (FM II). The ranking of the most frequent allergens in the FMs is largely unchanged, except for an increase in sensitization to hexyl cinnamal. Limitations of exposure to oakmoss absolute, isoeugenol and HICC in cosmetics and body care products had a positive effect, as confirmed by the declining proportions of sensitized patients. Nevertheless, they remain the most important fragrance allergens in FM I and FM II. FM I and FM II are valuable tools for screening for fragrance allergy. However, a diagnosis of fragrance allergy cannot be made by patch testing with FM I and FM II alone. In case of suspected fragrance allergy and/or positive test reaction to FM I or FM II, testing the full mix breakdown and other fragrance allergens is obligatory.