Sodium Benzoate as an Emerging but Problematic Allergen: Retrospective Analysis of Patch Test Results in 3198 Cases Underlines the Need for an Improved Test Preparation, as Even Dubious Reactions May Be Clinically Relevant

IF 4.8 1区医学 Q2 ALLERGY

Contact Dermatitis Pub Date : 2025-05-07 DOI:10.1111/cod.14803

Nicholas J. Lawrance, Catherine R. Holden, David J. Gawkrodger

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引用次数: 0

Abstract

Background

Sodium benzoate is increasingly used as a preservative in personal care products and in foods. Recently published experience of patch testing sodium benzoate at 5% in pet shows it to be an allergen that may be assuming increasing clinical relevance.

Objectives

We set out to define the prevalence of clinically relevant reactions to sodium benzoate, to delineate problems with the interpretation of patch test readings to this allergen and to identify whether its inclusion in various series offers additional diagnostic benefit beyond those offered by commonly tested allergens, for example benzoic acid and Myroxylon pereirae , with which it may show some cross reactivity.

Methods

From 2008 to 2023, 3198 patients were patch tested to 5% sodium benzoate in pet, which has been included in our bakery/cheilitis, fragrance and facial series. Types of reaction, clinical relevance and cross-reactivities were noted.

Results

Of 3198 subjects tested to 5% sodium benzoate in pet, 57 (1.8%) had an allergic positive reaction (+/++), 53 (1.6%) had a doubtful reaction (?+) and 133 (4.1%) had an irritant reaction (IR) – meaning that ?+ or irritant reactions were more than three times more common than allergic responses. Clinical relevance was identified in 67% (38 of 57) of + or ++ reactors to sodium benzoate, and in 36% (19 of 53) of those with doubtful (?+) reactions.

Co-reactivity to benzoic acid was seen in 15.4% of cases + or ++ to sodium benzoate.

The positivity ratio (the proportion of + reactions compared to ++ and +++) was 96.5% and the reaction index (number of allergic positives compared to ?+ or IR) was −0.53. Both indices indicate a problematic allergen.

Conclusions

This series reaffirms that sodium benzoate is an important allergen which should be included in bakery/cheilitis, fragrance and facial series in addition to benzoic acid and Myroxylon pereirae, with which it occasionally cross-reacts. However, it is tricky to test and its reactions are difficult to interpret—underlining the need to refine the preparation used for patch testing.

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苯甲酸钠作为一种新兴但有问题的过敏原：对3198例斑贴试验结果的回顾性分析强调了改进试验准备的必要性，因为即使是可疑的反应也可能具有临床相关性。

背景：苯甲酸钠越来越多地被用作个人护理产品和食品中的防腐剂。最近发表的对宠物进行5%苯甲酸钠贴片测试的经验表明，苯甲酸钠是一种可能越来越具有临床意义的过敏原。目的：我们开始定义对苯甲酸钠的临床相关反应的流行程度，描述对该过敏原的斑贴试验读数的解释问题，并确定将其纳入各种系列是否提供了比通常测试的过敏原（例如苯甲酸和密丝ylon pereirae）提供的额外诊断益处，它可能与这些过敏原表现出一些交叉反应性。方法：2008年至2023年，对3198例患者进行5%苯甲酸钠宠物贴片试验，该产品已纳入我公司烘焙/口服炎、香精和面部系列产品。记录反应类型、临床相关性和交叉反应性。结果：在3198名接受5%苯甲酸钠pet检测的受试者中，57人（1.8%）出现过敏阳性反应（+/++），53人（1.6%）出现可疑反应（?+），133人（4.1%）出现刺激反应（IR），即？+或刺激反应的发生率是过敏反应的3倍以上。对苯甲酸钠有+或++反应的67%（57例中的38例）和有可疑反应的36%（53例中的19例）确定了临床相关性。对苯甲酸钠+或++的病例中，对苯甲酸的共反应率为15.4%。阳性比率（+反应与++和++反应的比例）为96.5%，反应指数（过敏阳性数与？+或IR的比例）为-0.53。这两项指标都表明过敏原存在问题。结论：本系列研究再次确认了苯甲酸钠是除苯甲酸、褐梭菌偶有交叉反应外，面包/口角炎、香精、美容产品中应纳入的重要过敏原。然而，它的测试很棘手，其反应也很难解释，这就强调了改进用于贴片测试的制剂的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contact Dermatitis 医学-过敏

CiteScore

4.60

自引率

30.90%

发文量

227

审稿时长

4-8 weeks

期刊介绍： Contact Dermatitis is designed primarily as a journal for clinicians who are interested in various aspects of environmental dermatitis. This includes both allergic and irritant (toxic) types of contact dermatitis, occupational (industrial) dermatitis and consumers" dermatitis from such products as cosmetics and toiletries. The journal aims at promoting and maintaining communication among dermatologists, industrial physicians, allergists and clinical immunologists, as well as chemists and research workers involved in industry and the production of consumer goods. Papers are invited on clinical observations, diagnosis and methods of investigation of patients, therapeutic measures, organisation and legislation relating to the control of occupational and consumers".