Patch Testing With Tocopherol and Tocopherol Acetate: The North American Contact Dermatitis Group Experience, 2001 to 2016.

Abstract

BACKGROUND:

Vitamin E (tocopherol) a naturally occurring mixture of antioxidants commonly used in topical skin care products, may cause allergic contact dermatitis.

OBJECTIVE:

The aim of this study was to characterize positive patch test reactions to tocopherol and tocopherol acetate.

METHODS:

This is a retrospective analysis of North American Contact Dermatitis Group patch test data to tocopherols (dl-α-tocopherol 100% and/or dl-α-tocopherol acetate 100%) from 2001 to 2016.

RESULTS:

Of the 38,699 patients patch tested to tocopherol and/or tocopherol acetate, 349 (0.9%) had positive reactions; of these, 87.6% were currently relevant. Most (51.4%) were weak (+) and/or not related to occupation (99.1%). Compared with tocopherol-negative patients, tocopherol-positive individuals were more likely to be female (72.5% vs 67.2%, P = 0.0355), have a final primary diagnosis of allergic contact dermatitis (74.2% vs 52.6%, P < 0.0001), and have dermatitis in a scattered generalized distribution (23.8% vs 18.2%, P = 0.0072); they were also less likely to have hand involvement (16.6% vs 22.3%, P = 0.0064). The most common source of tocopherol was personal care products, especially moisturizers.

CONCLUSIONS:

Positive patch test reactions to tocopherols were relatively rare given their widespread use. When positive, current clinical relevance was high. Tocopherol-positive patients were more likely to be female and presented with dermatitis on the face or in a scattered generalized pattern.

• Authors: Erin M Warshaw, Jenna L Ruggiero, Joel G DeKoven, Jonathan I Silverberg, Howard I Maibach, James S Taylor, Amber R Atwater, Kathryn A Zug, Denis Sasseville, Joseph F Fowler Jr, Anthony F Fransway, Melanie D Pratt, Donald V Belsito, Vincent A DeLeo, Margo J Reeder
• Journal: Dermatitis : contact, atopic, occupational, drug (Dermatitis) 2021 Sep-Oct 01 Vol. 32 Issue 5 Pg. 308-318 ISSN: 2162-5220 [Electronic] United States
• PMID: 34238818 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 American Contact Dermatitis Society. All Rights Reserved.

Chemical References

• Antioxidants
• Cosmetics
• Tocopherols

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antioxidants (adverse effects, analysis)
• Child
• Child, Preschool
• Cosmetics (adverse effects, chemistry)
• Dermatitis, Allergic Contact (diagnosis, epidemiology)
• Female
• Humans
• Infant
• Male
• Middle Aged
• Patch Tests
• Retrospective Studies
• Tocopherols (adverse effects, analysis)
• Young Adult