Association between positive patch tests to epoxy resin and fragrance mix I ingredients

BACKGROUND: Both epoxy resin (diglycidyl ether of bisphenol A) and fragrance mix I are included in the European baseline series of contact allergens. A significant association between positive reactions to epoxy resin and fragrance mix has been reported by others. OBJECTIVE: To investigate and possibly reproduce this association with the use of TRUE((R)) test data and supplementary tests with fragrance mix ingredients from the Department of Dermatology, Odense University Hospital. MATERIALS AND METHODS: Six thousand one hundred and fifteen consecutive eczema patients tested from 1995 to 2007 were included, and test results from all patients tested with fragrance mix ingredients were analysed. RESULTS: One hundred and forty-five (2.4%) were positive to epoxy resin and 282 (4.6%) were positive to fragrance mix I. Nineteen were positive to both giving an odds ratio of 3.3, which is significant (95% CI 2.0-5.4). Analysis of association to individual fragrance mix ingredients showed a significant association to alpha-amyl cinnamal and isoeugenol. CONCLUSIONS: The significant association between positive reactions to epoxy resin and fragrance mix I was reproduced. However, the clinical implications are not clarified, and even though the association may be coincidental, the fact that it can be reproduced with a different patch test system and in a different population speaks against a random result. Further studies may help to interpret the association.