Positive patch test reactions to lanolin: cross-sectional data from the north american contact dermatitis group, 1994 to 2006.

Warshaw EM, Nelsen DD, Maibach HI, Marks JG, Zug KA, Taylor JS, Rietschel RL, Fowler JF, Mathias CG, Pratt MD, Sasseville D,Storrs FJ, Belsito DV, DeLeo VA.
Dermatitis. 2009 Mar-Apr;20(2):79-88.

BACKGROUND: The prevalence of lanolin sensitivity in referred patients is less than 4%.

OBJECTIVES: To (1) describe patients with positive patch-test reactions to lanolin, (2) determine clinical and occupational relevance associated with reactions to lanolin and common sources, and (3) examine the frequency of co-reacting allergens.

METHODS: A retrospective analysis of 26,479 patients patch-tested by the North American Contact Dermatitis Group (NACDG), 1994 to 2006.

RESULTS: Overall, 2.5% of patients (643 of 25,811) tested to lanolin alcohol 30% in petrolatum had positive reactions. Prevalence decreased from 3.7% in 1996 to 1998 to 1.8% in 2005 to 2006 (p <.0001); 83.4% of all positive reactions were currently relevant, but only 2.5% were occupationally relevant. Lanolin-positive patients were 1.2 times more likely to be male and 1.4 times more likely to have a history of atopic dermatitis when compared to allergic, but lanolin-negative, patients (p < .0002 and p < .0001, respectively). Cosmetics were the most common source. Lanolin-positive patients were significantly more likely to be co-sensitized to another NACDG standard screening allergen (p <.0001).

CONCLUSIONS: The prevalence of allergic patch-test reactions to lanolin in North America patch-test populations is decreasing. Current relevance of reactions was high, but occupational relevance was low. Concomitant reactions were more common in lanolin-positive patients.

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