Allergic contact dermatitis from ('hypoallergenic') adhesives containing D-limonene

BACKGROUND Besides being a potential component of (some species of) colophonium, D-limonene is also used as a tackifier in the production of adhesives. Hydroperoxides of limonene are well-known skin sensitizers. OBJECTIVES To show that D-limonene may be present in colophonium-containing but also colophonium-free ("hypoallergenic") adhesives, and that patients suffering from allergic contact dermatitis (ACD) from both types of adhesives might display positive patch test reactions to limonene hydroperoxides in this regard. PATIENTS AND METHODS Five patients with suspected ACD from adhesives were patch tested to the baseline series (containing limonene hydroperoxides 0.3 and 0.2% pet.), additional series, and, if available, to the culprit adhesives. The adhesives labelled as containing colophonium (n= 3) or free from it (n=2) were analysed with gas chromatography - mass spectrometry (GC-MS) for the presence of D-limonene. RESULTS All 5 patients sensitized to adhesives had (strong) positive patch test reactions to limonene hydroperoxides. The presence of D-limonene, and/or related components, could be demonstrated in all 3 colophonium-containing and, surprisingly, also in 2 colophonium-free ("hypoallergenic") tapes. CONCLUSIONS D-limonene may be present in both regular and "hypoallergenic" adhesives, with limonene hydroperoxides potentially contributing to ACD from such medical devices. The use of fragrance chemicals in adhesives deserves further research. This article is protected by copyright. All rights reserved.