Patch testing with fragrance mix II: results of the IVDK 2005-2008.

BACKGROUND The fragrance mix (FM I), established in 1977, detects the majority, but not all cases of contact allergy to fragrances. Based on European research 2002/2003, fragrance mix II (FM II) was developed to supplement FM I. In 2005, the German Contact Dermatitis Research Group (DKG) added FM II to their baseline series. OBJECTIVES To evaluate reactions to FM II and its constituents in routine patch testing. METHODS Retrospective data analysis of the Information Network of Departments of Dermatology (IVDK), 2005-2008, of patch test results with FM II and its constituents. RESULTS A total of 35 633 patients were patch tested with FM II as part of the DKG baseline series. Of these, 1742 (4.9%) reacted positively. Concomitant reactions to FM I were observed in 41.9% of the patients reacting to FM II. In 367 FM II-positive patients, a full breakdown test of the mix was performed. Of these, 47.7% reacted to hydroxyisohexyl 3-cyclohexene carboxaldehyde, 16.1% to citral, 11.4% to farnesol, 3.8% to hexyl cinnamal, 2.7% to coumarin, and 2.5% to citronellol. CONCLUSIONS FM II is an important screening and diagnostic tool to detect fragrance allergy. Hydroxyisohexyl 3-cyclohexene carboxaldehyde is the most important fragrance allergen in FM II.