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its inhibitory effect on matrix metalloproteinase-1 expression in UV-irradiated human dermal fibroblasts FEMS Microbiol Lett 2005;251:347 Dick LA Colloidal emollient baths in pediatric dermatoses Arch Pediatr 1958;75:506 Sompayrac LM, Ross C Colloidal oatmeal in atopic dermatitis of the young J Fla Med Assoc 1959;45:1411 Grais ML Role of colloidal oatmeal in dermatologic treatment of the aged AMA Arch Derm Syphilol 1953;68:402 US Food and Drug Administration Title 21: Food and Drugs, 1: Food and Drug Administration Department of Health and Humans Services, Subchapter D: Drugs for human use, Part 347: Skin protectant drug products for over-the-counter human use US Dept of Health and Human Services, FDA;21 CFR347 April 1, 2007 Smith GC The treatment of various dermatoses associated with dry skin JSC Med Assoc 1958;54:282 Dick LA Colloidal emollient baths in geriatric dermatoses Skin (Los Angeles) 1962;1:89 Vi K, Cours-Darne S, Vienne MP, et al Modulating effects of oatmeal extracts in the sodium lauryl sulfate skin irri-
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tancy model Skin Pharmacol Appl Skin Physiol 2002;15:120 133 Matheson JD, Clayton J, Muller MJ The reduction of itch during burn wound healing J Burn Care Rehabil 2001;22:76 134 Boisnic S, Branchet-Gumila MC, Coutanceau C Inhibitory effect of oatmeal extract oligomer on vasoactive intestinal peptide-induced inflammation in surviving human skin Int J Tissue React 2003;25:41 135 Chen CY, Milbury PE, Kwak HK, et al Avenanthramides and phenolic acids from oats are bioavailable and act synergistically with vitamin C to enhance hamster and human LDL resistance to oxidation J Nutr 2004;134:1459 136 Tsao R, Akhtar MH Neutraceuticals and functional foods: I Current trend in phytochemical antioxidant research J Food Agric Environ 2005;3:10 137 Saeed SA, Butt NM, McDonald-Gibson WJ, et al Inhibitors of prostaglandin biosynthesis in extracts of oat (Avena sativa) seeds Biochem Soc Trans 1981;9:444 138 Wallo W, Nebus J, Nystrand G Agents with adjunctive potential in atopic dermatitis J Am Acad Dermatol 2007; 56(suppl 2):AB70tract P712 139Vitoux D, Chappuis P, Arnaud J, et al Selenium, glutathione peroxidase, per-
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oxides and platelet functions Ann Biol Clin (Paris) 1996;54:181 Leverkus M, Yaar M, Eller MS, et al Post-transcriptional regulation of UV induced TNF-alpha expression J Invest Dermatol 1998;110:353 McKenzie RC Selenium, ultraviolet radiation and the skin Clin Exp Dermatol 2000;25:631 Stewart MS, Cameron GS, Pence BC Antioxidant nutrients protect against UVB-induced oxidative damage to DNA of mouse keratinocytes in culture J Invest Dermatol 1996;106:1086 Rico MJ Rising drug costs: the impact on dermatology Skin Therapy Lett 2000;5:1 Arora RB, Kapoor V, Basu N, et al Antiinflammatory studies on Curcuma longa (turmeric) Indian J Med Res 1971;59:1289 Srivastava R Inhibition of neutrophil response by curcumin Agents Actions 1989;28:298 Srimal RC, Dhawan BN Pharmacology of diferuloyl methane (curcumin), a non-steroidal anti-inflammatory agent J Pharm Pharmacol 1973;25:447 Srivastava R, Srimal RC Modification of certain inflammation-induced biochemical changes by curcumin Indian J Med Res 1985;81:215
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CHAPTER 36 Fragrance
An epidemiologic survey in the United Kingdom published in 2004 reported that 23% of women and 138% of men displayed adverse reactions to a personal care product (eg, deodorants and perfumes, skin care products, hair care products, and nail cosmetics) over the course of 1 year4 More recently, in a 1999 to 2006 Brazilian study of 176 patients (154 women and 22 men) seen in a private office who complained of dermatoses resulting from cosmetics, 45% exhibited dermatoses linked to cosmetics and 14% had skin lesions that were found to be caused by inappropriate use of cosmetics5 In addition, several studies have demonstrated that approximately 10% of dermatologic patients who are patch tested for 20 to 100 ingredients exhibit allergic sensitivity to at least one ingredient common in cosmetic products4 Fragrances and preservatives are the most common allergens and women aged 20 to 60 years represent the demographic group that experiences the majority of these reactions6 Individuals who are overexposed to skin care products and patients with an impaired stratum corneum, as manifested by dry skin, reportedly have increased susceptibility to allergic reactions7 Contact allergy caused by fragrances is typically seen as axillary dermatitis, dermatitis of the face (including the eyelids) and neck, hand dermatitis, and eruptions in locations where perfume may be dabbed on or sprayed such as the wrists and behind the ears8 It is important to note that while the overall risk of allergic reaction to fragrances is low, the absolute numbers of individuals affected by fragrance allergy is significant, and estimated to be 1% of the general population8 TABLE 36-1 Fragrance Mix (FM) I Oak moss Isoeugenol Eugenol Cinnamic aldehyde Geraniol Hydroxycitronellal Cinnamic alcohol -Amyl cinnamic aldehyde
Innovative products and procedures inundate medicine and the specialty of dermatology at a dizzying pace At the same time, the billion-dollar beauty industry continues to expand, with few if any signs of a decline The global fragrance and flavor market represents a significant and lucrative subdivision of the beauty market and is constantly testing various fragrance ingredients to stay ahead of encroaching regulation and increased rates of sensitization Indeed, while contact allergy to fragrance is not a presentation seen in the dermatologist s office as frequently as acne, for example, it is a common problem seen often throughout the world This is not surprising since fragrances are virtually omnipresent in products that come into contact with the skin, for example, soaps, body lotions and moisturizers, shampoos, deodorants, shaving products, cosmetics, perfumes, sunscreens, and dental products, as well as food products, detergents, and even air fresheners Furthermore, as stated in 18, fragrances consistently place among the top 10 contact dermatitis allergens and represent the second most common allergen family associated with allergic contact dermatitis, second only to nickel, as well as the most often cited cause of such reactions to cosmetic products This looms as an especially important realization given the general rise in the incidence of contact allergy to various fragrances and the fact that epidemiologic and human allergen sensitization studies have shown that individuals who are found to be sensitive to one allergen through patch testing are at significantly greater risk of having a second allergen identified1 3 Particularly, given the greater expertise expected of cosmetic dermatologists regarding agents intended to beautify the skin, it is incumbent upon such specialists to have a strong working knowledge of the primary fragrances identified as provoking allergic reactions This chapter will focus briefly on selected problematic fragrances, primarily on the worst offenders found within the Fragrance Mix (FM) I and FM II
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