Lanolin Allergic Reactions: North American Contact Dermatitis Group Experience, 2001 to 2018

Authors

• Jonathan I. Silverberg, From the Department of Dermatology, George Washington University School of Medicine, Washington, DC.
• Nisha Patel, From the Department of Dermatology, George Washington University School of Medicine, Washington, DC.
• Erin M. Warshaw
• Joel G. DeKoven, Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
• Amber R. Atwater, Department of Dermatology, Duke University Medical Center, Durham, NC.
• Donald V. Belsito, Department of Dermatology, Columbia University, New York, NY.
• Cory A. Dunnick, Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora.
• Marie-Claude Houle, Division of Dermatology, CHU de Québec, Laval University, Canada.
• Margo J. Reeder, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison.
• Howard I. Maibach, Department of Dermatology, University of California San Francisco.
• Kathryn A. Zug, Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
• James S. Taylor, Department of Dermatology, Cleveland Clinic, OH.
• Denis Sasseville, Division of Dermatology, Montreal General Hospital, McGill University, Quebec, Canada.
• Anthony F. Fransway, Associates in Dermatology, Fort Myers, FL.
• Vincent A. DeLeo, Division of Dermatology, University of Ottawa, Ontario, Canada.
• Melanie D. Pratt, Division of Dermatology, University of Louisville, KY.
• Joseph F. Fowler, Department of Dermatology, Ohio State University, Columbus.
• Matthew J. Zirwas

Document Type

Journal Article

Publication Date

5-1-2022

Journal

Dermatitis : contact, atopic, occupational, drug

Volume

33

Issue

3

DOI

10.1097/DER.0000000000000871

Abstract

BACKGROUND: Lanolin is an important cause of allergic contact dermatitis. OBJECTIVES: The aims of this study were to describe the epidemiology of lanolin allergy and to assess trends in patch test reactions to lanolin over time. METHODS: This study used a retrospective analysis of patients patch tested with lanolin alcohol 30% or Amerchol L-101 50% in petrolatum by the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,691). RESULTS: Overall, 1431 (3.3%) had a positive reaction, and 1238 (2.8%) were currently relevant. Prevalence of lanolin allergy was 4.63% between 2011 and 2018 (P < 0.0001). Most lanolin-allergic patients had + (52%) reactions; 18%, and 6% had ++ and +++ reactions, respectively. Common primary anatomic sites of dermatitis were the hands (20.7%), scattered/generalized distribution (19.6%), and face (17.0%). Allergic reactions to lanolin were more common in children (4.5%) than in adults (3.2%, P = 0.0018). Compared with nonallergic patients, lanolin-allergic patients were more likely to have history of eczema or hay fever, male sex, older than 40 years, or Black race (P < 0.05). Common lanolin sources were personal care products and drugs/medications. Only 2.24% of the positive reactions were linked to occupation. CONCLUSIONS: Lanolin sensitivity was common. Reactions were often clinically relevant and linked to personal care products and medications.

APA Citation

Silverberg, Jonathan I.; Patel, Nisha; Warshaw, Erin M.; DeKoven, Joel G.; Atwater, Amber R.; Belsito, Donald V.; Dunnick, Cory A.; Houle, Marie-Claude; Reeder, Margo J.; Maibach, Howard I.; Zug, Kathryn A.; Taylor, James S.; Sasseville, Denis; Fransway, Anthony F.; DeLeo, Vincent A.; Pratt, Melanie D.; Fowler, Joseph F.; and Zirwas, Matthew J., "Lanolin Allergic Reactions: North American Contact Dermatitis Group Experience, 2001 to 2018" (2022). GW Authored Works. Paper 1019.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1019

Department

Dermatology