Ammonium persulfate (APS), an oxidizing agent used in hair products, manufacturing, and pool/spa water, can cause skin reactions including allergic contact dermatitis.
To characterize positive patch test reactions to APS (2.5% pet).
Retrospective analysis of patients tested to the North American Contact Dermatitis Group (NACDG) screening series from 2015-2018.
Of 10,526 patients, 193 (1.8%) had positive patch test reactions to APS. Compared to negative patients, APS-positive patients were significantly more likely to be male (43.2% vs. 28.0%, p<0.0001), have primary hand (30.2% vs. 22.0%, p=0.0064), scattered generalized (25.5% vs. 17.9%, p=0.0064), or trunk dermatitis (8.9% vs. 4.9%, p=0.0123), and occupationally-related dermatitis (22.2% vs. 10.9%, p<0.0001). Over half of the APS-positive reactions were currently relevant (57.0%); 19 (9.8%) were related to occupation, especially (68.4%) hairdressers. Swimming pools/spas (23.3%) and hair care products (19.2%) were the most common APS sources.
Immediate reactions and follow-up testing not captured.
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 are important sources of APS exposure.

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