Patch Testing with Decyl and Lauryl Glucoside: How Well Does One Screen for Contact Allergic Reactions to the Other?

BACKGROUND: Alkyl glucoside surfactants, present in many cosmetic products, can cause allergic contact dermatitis. Decyl glucoside has been part of the North American Contact Dermatitis Group standard allergen panel since 2009. OBJECTIVES: This study aimed to identify rates and relevance of positive patch test reactions to decyl and lauryl glucosides and to determine how well one of these glucosides screens for contact allergic reactions to the other. METHODS: A retrospective analysis was performed on 897 patients suspected of having a cosmetic-related dermatitis and patch tested with both decyl and lauryl glucosides between 2009 and 2016. RESULTS: Forty-eight patients (5%) had positive reactions to decyl glucoside and/or lauryl glucoside. Among the alkyl glucoside-allergic patients, 65% had positive reactions to both decyl and lauryl glucosides. In 41% of cases, reactions were of definite or probable relevance. In approximately 55% of cases, reactions were of possible relevance. CONCLUSIONS: Sixty-five percent of glucoside-allergic patients exhibited co-reactions to decyl and lauryl glucosides. Thus, neither glucoside is an adequate screen for allergy to the other. Given that these reactions are often relevant, clinicians should patch test with decyl, lauryl, and other alkyl glucosides in cases of suspected cosmetic allergy.