Positive patch test reactions to oxidized limonene: Exposure and relevance

Johanna Bråred Christensson, Klaus E. Andersen, Magnus Bruze, Jeanne D. Johansen, Begoña Garcia-Bravo, Ana Gimenez Arnau, Chee Leok Goh, Rosemary Nixon, Ian R. White

    Research output: Contribution to journalArticleResearchpeer-review

    28 Citations (Scopus)


    © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Background R-Limonene is a common fragrance terpene found in domestic and industrial products. R-Limonene autoxidizes on air exposure, and the oxidation products can cause contact allergy. In a recent multicentre study, 5.2% (range 2.3-12.1%) of 2900 patients showed a positive patch test reaction to oxidized R-limonene. Objective To study the exposure to limonene among consecutive dermatitis patients reacting to oxidized R-limonene in an international setting, and to assess the relevance of the exposure for the patients' dermatitis. Methods Oxidized R-limonene 3.0% (containing limonene hydroperoxides at 0.33%) in petrolatum was tested in 2900 consecutive dermatitis patients in Australia, Denmark, the United Kingdom, Singapore, Spain, and Sweden. A questionnaire assessing exposure to limonene-containing products was completed. Results Overall, exposure to products containing limonene was found and assessed as being probably relevant for the patients' dermatitis in 36% of the limonene-allergic patients. In Barcelona and Copenhagen, > 70% of the patients were judged to have had an exposure to limonene assessed as relevant. Conclusions Oxidized R-limonene is a common fragrance allergen, and limonene was frequently found in the labelling on the patients' products, and assessed as relevant for the patients' dermatitis. A large number of domestic and occupational sources for contact with R-limonene were identified.
    Original languageEnglish
    Pages (from-to)264-272
    JournalContact Dermatitis
    Issue number5
    Publication statusPublished - 1 Nov 2014


    • allergic contact dermatitis
    • autoxidation
    • fragrance allergy
    • hydroperoxide
    • limonene
    • oxidation products
    • patch test
    • relevance
    • terpenes


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