SINT MAARTEN, NETHERLANDS ANTILLES — The North American Contact Dermatitis Group removed 5 allergens from its 2007–2008 standard North American patch test tray and replaced them with 10 new substances to test for in 2009–2010.
The group removed imidazolidinyl urea, 2%; dimethylol dimethyl hydantoin, 1%; diazolidinyl urea, 1%; bisphenol F epoxy resin, 0.025%; and triamcinolone acetonide, 1%, Dr. Kathryn A. Zug reported at the Caribbean Dermatology Symposium.
The 10 allergens added are:
▸ Dimethylaminopropylamine (DMAPA), 1%. “You may be hearing more about this allergen. DMAPA is found in body wash, shampoos, and detergents and can cause face, neck, and eyelid dermatitis,” said Dr. Zug, a dermatologist at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. She said she had no relevant disclosures to report.
▸ D-Limonene, 3%.
▸ Shellac, 20%. “This has been described previously for eyelid dermatitis from mascara,” Dr. Zug said.
▸ Majantole, 5%. She described this as “a new, important fragrance allergen” from a synthetic source.
▸ Oleamidopropyl dimethylamine, 0.1%.
▸ Carvone, 5%.
▸ Lavandula angustifolia (lavender) oil, 2%.
▸ Decyl glucoside, 5%. “This plant-derived surfactant is included in more 'natural' products,” Dr. Zug said. “It's an uncommon allergen, but the North American Contact Dermatitis Group is now monitoring it.”
▸ Jasminum officionale oil (Jasminum grandiflorum), 2%.
▸ Mentha piperita (peppermint) oil, 2%.
An allergen that sounds new, but is not, is Myroxylon pereirae resin. “This is one of our familiar allergens, balsam of Peru,” Dr. Zug said. “What has happened? We've taken a simple name—balsam of Peru—and made it more complicated by adopting the botanical name.”
She added, “Hopefully you will all be familiar with it when you see it on a standard tray.”
In discussing the results of a study of allergies to fragrances, Dr. Zug noted that a Lyral sensitization frequency of 2.3% was reported in a comprehensive study of 26 fragrances patch tested in a total of 21,325 patients in Germany (Contact Derm. 2007;57:1–10). Lyral is a component of fragrances and detergents included in the Fragrance Mix II patch test kit.
“Europeans are very interested in figuring out the frequency of [fragrance] allergies,” Dr. Zug said.
Other fragrances not on the standard series that were associated with stronger or more frequent patch test results in the study included tree moss (2.4%), oak moss (2.0%), hydroxycitronellal (1.3%), isoeugenol (1.1%), and cinnamic aldehyde (1.0%).
Because of studies like this, Dr. Zug said, “we may be able to better hone down which fragrance components our patients are allergic to, rather than just telling them they have a fragrance allergy.”
Products Recommended For Very Sensitive Skin
Creams
Aveeno
Vanicream
Deodorant
Almay
Lotions
Aveeno
DML
Theraplex emollient
Ointments
Hydrolatum
Vaseline petroleum jelly
Shampoos and Conditioners
DHS Clear
Free and Clear
Soaps
All liquid washes
Glycerin soap
Vanicream bar
Aveeno bar
Source: Dr. Zug