Contact sensitization to limonene and linalool hydroperoxides in Spain: a GEIDAC prospective study

Summary Background Limonene and linalool are common fragrance terpenes widely used in cosmetic, household and hygiene products. Their primary oxidation products formed after air exposure, the hydroperoxides, have been recognized as important contact haptens. Objectives To investigate the prevalence of contact allergy to hydroperoxides of limonene (Lim‐OOHs) and hydroperoxides of linalool (Lin‐OOHs) in Spain, and to define the optimal concentration for screening in consecutive patients. Methods Three different concentrations of Lim‐OOHs (0.1%, 0.2% and 0.3% pet.) and Lin‐OOHs (0.25%, 0.5% and 1.0% pet.) were simultaneously tested in 3639 consecutive patients at 22 departments of dermatology in Spain. Results Lim‐OOHs at 0.1%, 0.2% and 0.3% yielded positive patch test reactions in 1.4%, 3.4% and 5.1% of the tested patients, respectively; and Lin‐OOHs at 0.25%, 0.5% and 1.0% yielded positive reactions in 1.3%, 2.9% and 4.9% of the tested patients, respectively. Few irritant (1.5–1.9%) and doubtful reactions (0.4–0.5%) to both terpene hydroperoxides were registered at the highest concentrations tested. Conclusions Lim‐OOHs and Lin‐OOHs can be considered as common causes of contact allergy, and their inclusion in an extended baseline patch test series therefore seems to be appropriate. The patch test preparations of Lim‐OOHs 0.3% pet. and Lin‐OOHs 1.0% pet. are useful tools for screening of contact sensitization.