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Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101
Author(s) -
Knijp Jannet,
Bruynzeel Derk P.,
Rustemeyer Thomas
Publication year - 2019
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.13210
Subject(s) - lanolin , patch test , allergy , medicine , patch testing , confidence interval , allergen , odds ratio , alcohol , contact allergy , contact dermatitis , dermatology , chemistry , chromatography , immunology , organic chemistry
Background The prevalence of lanolin contact allergy in dermatitis patients varies from 1.2% to 6.9%. Different lanolin derivatives are used in patch testing. Objectives To determine which combination of lanolin derivatives is most effective in patch testing for the diagnosis of lanolin contact allergy. Methods A retrospective analysis of patients patch tested between 2016 and 2017 was performed. Patients were eligible if they had been tested with lanolin alcohol 30% pet., Amerchol L101 50% pet., and a supplementary series containing other lanolin derivatives. Lanolin alcohol and Amerchol L101 were tested in duplicate. Results Of 594 patients, 28.6% (95% confidence interval [CI]: 25.1%‐32.3%) had a positive patch test reaction to at least one lanolin derivative. Reactions to lanolin alcohol (14.7%, 95%CI: 11.3%‐18.2%) and Amerchol L101 (15.0%, 95%CI: 11.5%‐18.5%) were common in the routinely tested series. Reactions to other test preparations were significantly less frequent ( P < 0.05). The addition of Amerchol L101 to lanolin alcohol significantly increased the number of positive cases (odds ratio 1.79, P < 0.001). Conclusions The combination of lanolin alcohol and Amerchol L101 is effective in patch testing for the diagnosis of lanolin contact allergy. Routinely testing with other lanolin derivatives may not be worthwhile, as it detects only a few additional patients.