Patch testing with ammonium persulfate: The North American Contact Dermatitis Group Experience, 2015-2018
Journal of the American Academy of Dermatology
allergic contact dermatitis; ammonium persulfate; contact allergy; patch tests
Background: Ammonium persulfate (APS), an oxidizing agent used in hair products, manufacturing, and pool/spa water, can cause skin reactions, including allergic contact dermatitis. Objective: To characterize positive patch test reactions to APS (2.5% petrolatum). Methods: Retrospective analysis of patients tested to the North American Contact Dermatitis Group screening series from 2015 to 2018. Results: Of 10,526 patients, 193 (1.8%) had positive patch test reactions to APS. Compared with APS-negative patients, APS-positive patients were significantly more likely to be male (43.2% vs 28.0%; P <.0001); have primary hand dermatitis (30.2% vs 22.0%; P =.0064), scattered generalized dermatitis (25.5% vs 17.9%; P =.0064), or trunk dermatitis (8.9% vs 4.9%; P =.0123); and have dermatitis that is occupationally related (22.2% vs 10.9%; P <.0001). More than half of the APS-positive reactions were currently relevant (57.0%); 19 (9.8%) were related to occupation, especially hairdressers (68.4%). Swimming pools/spas (23.3%) and hair care products (19.2%) were the most common sources of APS. Limitations: Immediate reactions and follow-up testing were not captured. Conclusion: The proportion of patients positive to APS was 1.8%. APS positivity was significantly associated with male sex and hand dermatitis. Swimming pool/spa chemicals were important sources of APS exposure.
Warshaw, E., Ruggiero, J., DeKoven, J., Pratt, M., Silverberg, J., Maibach, H., Zug, K., Atwater, A., Taylor, J., Reeder, M., Sasseville, D., Fowler, J., Fransway, A., Belsito, D., DeLeo, V., Houle, M., & Dunnick, C. (2021). Patch testing with ammonium persulfate: The North American Contact Dermatitis Group Experience, 2015-2018. Journal of the American Academy of Dermatology, (). http://dx.doi.org/10.1016/j.jaad.2021.08.005