Title

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.

Department

Dermatology

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