Allergic contact dermatitis from dyes in wigs following diphencyprone treatment

Objectives:  To investigate symptoms from the eyes and airways, elicited by perfume and fragrance products and associations between such symptoms and skin prick test reactivity, metacholine bronchial hyperreactivity (BHR), contact allergy, and eczema in a population based sample.
Methods:  A questionnaire on mucosal symptoms elicited by fragrance products was mailed to 1189 persons who had participated in a Danish population‐based study of allergic diseases in 1997/98. The study included measurement of BHR, skin prick testing, patch testing and history of hand eczema.
Results:  The response rate to the questionnaire was 80%. Symptoms from the eyes or airways elicited by fragrance products were reported by 42%. There were no significant associations between these symptoms and skin prick test reactivity. Positive and independent statistical significant associations were found between BHR, perfume contact allergy and hand eczema, and symptoms from the eyes and airways elicited by fragrance products, also when adjusting for nickel contact allergy, age, gender psychological vulnerability, educational level and social class.
Conclusions:  Individuals with BHR, hand eczema and/or perfume contact allergy, as opposed to those without, are more frequently and more severely bothered from the eyes or airways after volatile exposure to fragrance products. The lack of association with skin prick test reactivity indicates that IgE mediated allergic mechanisms do not play a major role in the development of these symptoms. Having hand eczema has the greatest impact on reporting mucosal symptoms elicited by fragrance products.