Dermatitis, Allergic Contact

Cutaneous reactivity to challenge with dinitrochlorobenzene (DNCB) and diphenylcyclopropenone (DCP) was studied in 16 volunteers following hypnotic suggestions to increase and decrease response during sensitization. The immunoreactivity to DNCB and DCP was modulated by direct suggestions and guided imagery under hypnosis. The volunteers were highly susceptible subjects selected by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A. Measurement of skin reactions to the challenge 1 month after sensitization was performed double blindly.

Contact allergy to various essential oils used in aromatherapy was demonstrated on patch testing in a 53-year-old patient suffering from relapsing eczema resistant to therapy on various uncovered parts of the skin, in particular the scalp, neck and hands. Sensitization was due to previous exposure to lavender, jasmine and rosewood. Laurel, eucalyptus and pomerance also produced positive tests, although there was no hint of previous exposure. A diagnosis of allergic airborne contact dermatitis was thus established.

Ethereal oils are widely used, in food, toothpaste, as flavouring agents in perfumes and cosmetics, and in dermatological treatment, as antiseptics, adstringenta, antipruritic tinctures, lotions and pomades. The use of ethereal oils seems to have increased in recent years, probably due to a growing interest in alternative medicine, and especially aromatherapy. By describing the cases of three patients with allergic contact dermatitis, we wish to point out possible unwanted side effects of using ethereal oils.

This article reviews side-effects of fragrance materials present in cosmetics with emphasis on clinical aspects: epidemiology, types of adverse reactions, clinical picture, diagnostic procedures, and the sensitizers. Considering the ubiquitous occurrence of fragrance materials, the risk of side-effects is small. In absolute numbers, however, fragrance allergy is common, affecting approximately 1% of the general population.

Allergic contact dermatitis secondary to aromatherapy has been only rarely reported. We present 39-year-old woman who had used aromatherapy products for approximately 2 to 3 years who presented with an erythematous eruption on her face and chest. Patch testing showed a positive reaction to neomycin and fragrance mix. On cessation of her aromatherapy products, her eruption rapidly resolved. Aromatherapy products containing essential oils may need to be considered as a cause of allergic contact dermatitis because of the increasing popularity of this treatment.

BACKGROUND: Most dermatologists can recognize the classic patterns of presentation of plant contact dermatitis; however, few can recognize the offending plants or know the name and chemical structure of the allergens or irritants that they contain. OBJECTIVE: Five basic clinical patterns of phytodermatitis are reviewed: 1) allergic phytodermatitis, 2) photophytodermatitis, 3) irritant contact dermatitis, 4) pharmacologic injury, and 5) mechanical injury. The plants responsible for each pattern are presented by families, according to current scientific taxonomy.

Allergic contact dermatitis from the topical use of essential oils is not widely recognized as an occupational hazard. Four cases of allergic contact dermatitis to essential oils occurring in three aromatherapists and one chemist with a particular interest in aromatherapy are described. All presented with predominantly hand dermatitis and demonstrated sensitization to multiple essential oils. One patient developed a recurrence of cutaneous symptoms following ingestion of lemongrass tea.

Essential or fragrant oils are volatile odourous mixtures of organic chemical compounds that are widely used in aromatherapy and in the perfume industry. Because of their frequent use, allergy to essential oils is being increasingly recognized. We report 2 cases of multiple allergies to essential oils in professional aromatherapists. Gas chromatography/mass spectrometry was used to analyse the oils in order to identify a common allergen responsible for the contact dermatitis.

Our aim was to quantify and qualify the use of complementary medicine (CM) by patients referred to our contact dermatitis clinic in Leicester, UK. A face-to-face structured questionnaire study was made of 109 consecutive patients referred to the contact dermatitis clinic. 109 such questionnaires were completed. 21/109 (20%) of patients were Indo-Asian and 86/109 (79%) white Caucasian. 33/109 (30%) had tried some form of CM to treat their skin condition. This use was higher in the Indo-Asian group, where 13/21 (62%) had tried some form of CM.