Patch testing with ammonium persulfate: The North American Contact Dermatitis Group Experience, 2015-2018.

Abstract

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.

• Authors: Erin M Warshaw, Jenna L Ruggiero, Joel G DeKoven, Melanie D Pratt, Jonathan I Silverberg, Howard I Maibach, Kathryn A Zug, Amber R Atwater, James S Taylor, Margo J Reeder, Denis Sasseville, Joseph F Fowler Jr, Anthony F Fransway, Donald V Belsito, Vincent A DeLeo, Marie-Claude Houle, Cory A Dunnick
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 87 Issue 5 Pg. 1014-1023 (11 2022) ISSN: 1097-6787 [Electronic] United States
• PMID: 34390784 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Hair Preparations
• Oxidants
• Water
• ammonium peroxydisulfate
• Petrolatum
• Ammonium Sulfate

Topics

• Allergens
• Ammonium Sulfate
• Dermatitis, Allergic Contact (diagnosis, epidemiology, etiology)
• Dermatitis, Occupational (diagnosis, epidemiology, etiology)
• Eczema (complications)
• Female
• Hair Preparations (adverse effects)
• Humans
• Male
• North America
• Oxidants
• Patch Tests (adverse effects)
• Petrolatum
• Retrospective Studies
• Water