Concomitant reactions to geraniol and citral – due to cross reactivity?

• Background: Fragrance allergy is estimated as the second most common contact allergy in the western world, based on test results using the fragrance markers in the baseline series. One of these markers, fragrance mix (FM), contains geraniol at a concentration of 1%. Although about 10% of tested consecutive dermatitis patients react to FM, geraniol is responsible for only 5% of positive patch test reactions to the individual components of FM. However, we have shown that geraniol forms sensitizing compounds via autoxidation and skin metabolism. Geranial and neral, the two isomers in citral, are the major haptens formed in both of these activation pathways. Objectives: To investigate whether testing with oxidized (ox) geraniol detects more cases of contact allergy than testing with pure geraniol. The pattern of reactions to pure and ox geraniol, and the metabolites/autoxidation products geranial and neral was studied to investigate the importance of autoxidation or cutaneous metabolism in contact allergy to geraniol. Patients and methods: Pure and ox geraniol were tested at 2.0% pet in 2227 and 2179 consecutive patients, respectively. In parallel, geranial, neral and citral were tested in 2152, 1626, and 1055 consecutive patients, respectively. Results: Pure and ox geraniol detected positive patch test reactions in 0.13% and 0.55% of the patients, respectively. Eight of 11 patients with positive patch test reactions to ox geraniol also reacted to citral or its components. Relevance for the positive patch test reactions in relation to the patients´ dermatitis was found in 11 of 14 cases. Conclusions: Testing with ox geraniol could detect more cases of contact allergy to geraniol. The reaction pattern of the 14 cases presented indicates that both autoxidation and metabolism could be important in sensitization to geraniol. Concomitant reactions for geraniol and citral could be due to cross reactivity.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)

NATURVETENSKAP  -- Kemi (hsv//swe)

NATURAL SCIENCES  -- Chemical Sciences (hsv//eng)

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