Suspected fragrance allergy requires extended patch testing to individual fragrance allergens

This study has been performed to evaluate the efficacy of fragrance mix (FM ) as a screen for fragrance allergy Patients were included if they had had positive allergic reactions to FM, to 1 of the 8 ingredients of FM, to I of 14 other fragrance materials, or to their own perfume. 91 patients were st udied. There were 65 women and 23 men (in 3, their sex was not recorded) al lergic to FM on patch testing. The mean (+/-SD) age was 48.4+/-18.6 years. 22 patients gave a past history of atopic eczema. Dermatitis of the hands ( 31%) and face (26%) were the most common presenting complaints. 85 patients (93%) had a positive allergic patch test reaction to FM. 22 of the 40 test ed to the extended fragrance series were positive to other perfumes as well , and of these, there were 14 reactions (in 9 patients) to allergens not in the FM. In addition, 6 patients were positive only to separately tested fr agrance constituents and not to the FM. In conclusion, FM is an accurate sc reen for fragrance contact sensitivity. However, patch testing to an extend ed series is needed if there is clinical suspicion of perfume allergy, as o therwise about 7% of patients allergic to fragrances will be missed.