Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain.
Department of Dermatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Contact Dermatitis. 2022 Jul;87(1):1-12. doi: 10.1111/cod.14064. Epub 2022 Feb 23.
Limonene and linalool are among the most common fragrance terpenes used in everyday products. They are pre-haptens, forming hydroperoxides (Lim-OOHs, Lin-OOHs) upon oxidation and inducing frequent positive patch test reactions in patients with dermatitis, and yet they are not routinely tested in Europe. This review evaluates current patch testing with Lim-OOHs and Lin-OOHs by asking whether hydroperoxide patch testing is warranted, examining the difficulties or challenges related to reading and interpreting hydroperoxide patch test results with currently available material, and assessing their relevance. Studies are increasingly pointing to high percentages of positive reactions in patients consecutively patch tested with these oxidized products. An association between a positive clinical history and a strong patch test reaction has been described, but problems with doubtful/irritant reactions have also been reported. Considering the high frequency of relevant positive reactions, the incorporation of Lim-OOHs 0.3% and Lin-OOHs 1% in the baseline series may be justified. Since exposure, sensitization, and elicitation limits of Lim-OOHs and Lin-OOHs in the products still need to be better determined, an assessment of previous exposure, possible sensitizations, and reactions may help to improve the clinical assessment.
柠檬烯和芳樟醇是日用产品中最常见的香料萜烯之一。它们是预致敏原，在氧化后形成氢过氧化物（Lim-OOHs、Lin-OOHs），并在皮炎患者中频繁引起阳性斑贴试验反应，但在欧洲并未常规检测。本综述通过询问氢过氧化物斑贴试验是否合理，检查与目前可用材料相关的阅读和解释氢过氧化物斑贴试验结果的困难或挑战，并评估其相关性，来评估目前用 Lim-OOHs 和 Lin-OOHs 进行的斑贴试验。越来越多的研究表明，连续用这些氧化产品进行斑贴试验的患者中有很高比例的阳性反应。已经描述了阳性临床病史与强烈斑贴试验反应之间的关联，但也有报道称存在可疑/刺激性反应的问题。考虑到相关阳性反应的高频率，将 Lim-OOHs 0.3%和 Lin-OOHs 1%纳入基础系列可能是合理的。由于产品中 Lim-OOHs 和 Lin-OOHs 的暴露、致敏和引发限值仍需更好地确定，因此对以前的暴露、可能的致敏和反应进行评估可能有助于改善临床评估。
