Ten Years of Patch Testing to Hydroperoxides of Limonene and Linalool: Prevalence, Patterns and Clinical Insights

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Main Authors: Sofia Botvid, Rebekka Søgaard, Jakob Ferløv Baselius Schwensen, Jeanne Duus Johansen
Format: Artículo Open Access
Published: Wiley 2026
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author Sofia Botvid
Rebekka Søgaard
Jakob Ferløv Baselius Schwensen
Jeanne Duus Johansen
author_facet Sofia Botvid
Rebekka Søgaard
Jakob Ferløv Baselius Schwensen
Jeanne Duus Johansen
Sofia Botvid
Rebekka Søgaard
Jakob Ferløv Baselius Schwensen
Jeanne Duus Johansen
collection Wiley Open Access
contents Ten Years of Patch Testing to Hydroperoxides of Limonene and Linalool: Prevalence, Patterns and Clinical Insights Sofia Botvid Rebekka Søgaard Jakob Ferløv Baselius Schwensen Jeanne Duus Johansen Contact Dermatitis ABSTRACT Background Limonene and linalool are widely used fragrances in cosmetic and household products. Upon air exposure, they autoxidise into potent sensitisers – hydroperoxides of limonene (Lim‐OOH) and linalool (Lin‐OOH). Objectives The objective of this study is to investigate patch test reactions to Lim‐OOH and Lin‐OOH, and associated characteristics, reaction patterns, including doubtful reactions and co‐reactivity with other fragrance allergens. Method A retrospective analysis was conducted using registry data from 6719 consecutively patch‐tested patients at Gentofte Hospital, Denmark (2014–2025). Doubtful reactions were clinically subclassified as erythematous, only (E) or infiltrated (I). Results The prevalence of positive patch test reactions was 1.6% for Lim‐OOH and 3.1% for Lin‐OOH. Positive Lim‐OOH reactions were less likely in men and in patients with atopic, occupational or hand dermatitis, whilst positive Lin‐OOH reactions were more likely in those > 40 years and less in atopic dermatitis. Most reactions peaked on day 3/4 and were weakly positive. Doubtful I reactions more frequently progressed to positive than doubtful E. Co‐reactivity was observed between Lim‐OOH, Lin‐OOH and other fragrance allergens. Lower test concentrations reduced diagnostic sensitivity. Conclusion Co‐reactivity with other fragrance allergens supports true allergenicity. The currently recommended patch test concentrations (0.3% Lim‐OOH and 1.0% Lin‐OOH) seem optimal and qualify for inclusion in the European baseline series. 10.1111/cod.70102 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1111/cod.70102
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institution Wiley Open Access
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spellingShingle Ten Years of Patch Testing to Hydroperoxides of Limonene and Linalool: Prevalence, Patterns and Clinical Insights
Sofia Botvid
Rebekka Søgaard
Jakob Ferløv Baselius Schwensen
Jeanne Duus Johansen
Contact Dermatitis
Ten Years of Patch Testing to Hydroperoxides of Limonene and Linalool: Prevalence, Patterns and Clinical Insights Sofia Botvid Rebekka Søgaard Jakob Ferløv Baselius Schwensen Jeanne Duus Johansen Contact Dermatitis ABSTRACT Background Limonene and linalool are widely used fragrances in cosmetic and household products. Upon air exposure, they autoxidise into potent sensitisers – hydroperoxides of limonene (Lim‐OOH) and linalool (Lin‐OOH). Objectives The objective of this study is to investigate patch test reactions to Lim‐OOH and Lin‐OOH, and associated characteristics, reaction patterns, including doubtful reactions and co‐reactivity with other fragrance allergens. Method A retrospective analysis was conducted using registry data from 6719 consecutively patch‐tested patients at Gentofte Hospital, Denmark (2014–2025). Doubtful reactions were clinically subclassified as erythematous, only (E) or infiltrated (I). Results The prevalence of positive patch test reactions was 1.6% for Lim‐OOH and 3.1% for Lin‐OOH. Positive Lim‐OOH reactions were less likely in men and in patients with atopic, occupational or hand dermatitis, whilst positive Lin‐OOH reactions were more likely in those > 40 years and less in atopic dermatitis. Most reactions peaked on day 3/4 and were weakly positive. Doubtful I reactions more frequently progressed to positive than doubtful E. Co‐reactivity was observed between Lim‐OOH, Lin‐OOH and other fragrance allergens. Lower test concentrations reduced diagnostic sensitivity. Conclusion Co‐reactivity with other fragrance allergens supports true allergenicity. The currently recommended patch test concentrations (0.3% Lim‐OOH and 1.0% Lin‐OOH) seem optimal and qualify for inclusion in the European baseline series. 10.1111/cod.70102 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Ten Years of Patch Testing to Hydroperoxides of Limonene and Linalool: Prevalence, Patterns and Clinical Insights
topic Contact Dermatitis
url https://onlinelibrary.wiley.com/doi/10.1111/cod.70102