Temperature dependent primary irritant dermatitis from lemon perfume

In a recent outbreak of hand eczema amongst cleaning personnel after the introduction of a new, lemon‐scented detergent, it was noted that the patients complained of a burning, stinging sensation when their hands were submerged in hot detergent solutions. Since routine patch testing with the Standard Series and perfume components was of no help in pinpointing the responsible agent, testing with selected perfume components was repeated at higher temperatures. Identical tests were placed on both forearms for 20 min, one arm being exposed to 43°C. the other to 23–25 °C. Little or no reaction was seen on the “cold” arm, whereas the lemon perfume component Citral proved to be a strong primary irritant at higher temperatures.