Allergic patch test reactions associated with cosmetics: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004.

Warshaw EM, Buchholz HJ, Belsito DV, Maibach HI, Fowler JF Jr, Rietschel RL, Zug KA, Mathias CG, Pratt MD, Sasseville D, Storrs FJ, Taylor JS, Deleo VA, Marks JG Jr.
J Am Acad Dermatol. 2009 Jan;60(1):23-38. Epub 2008 Nov 6.

BACKGROUND: Allergy to cosmetics is common.

OBJECTIVES: We sought to characterize patients with positive patch test reactions associated with a cosmetic source, to identify common allergens; and to explore gender and occupational associations.

METHODS: We performed a retrospective, cross-sectional analysis.

RESULTS: Of 6621 female and 3440 male patients, 1582 female (23.8%) and 611 of male (17.8%) patients had at least one allergic patch test reaction associated with a cosmetic source. Of “allergic” patients (>1 allergic reaction, n = 6815), females were 1.21 times more likely to have an allergic reaction associated with a cosmetic source than were male patients (p < .0001, 95% confidence interval [CI] 1.12-1.31). Within the “cosmetic allergic” group (n = 2243), head and neck involvement was significantly higher in female than in male patients (49.3% vs 23.7%, p < .0001). One hundred twenty-five patients had occupationally related allergic reactions associated with a cosmetic.

LIMITATIONS: This study is limited by its cross-sectional, retrospective design.

CONCLUSION: Of all patients studied, 21.8% had an allergic reaction associated with a cosmetic. Site of dermatitis, cosmetic categories, and specific allergens differed somewhat by gender.

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