title: Hairdressers with dermatitis should always be patch tested regardless of atopy status.
abstract: BACKGROUND
  Allergic contact dermatitis is common in hairdressers because of their exposure to chemicals used in hair dyes and permanent wave solutions. Atopic individuals are known to have a higher prevalence of leaving the profession due to morbidity associated with hand eczema.
  
  
  OBJECTIVE
  To assess which chemicals are responsible for allergic contact dermatitis in hairdressers and whether the prevalence is the same according to atopy status.
  
  
  METHODS
  A total of 729 hairdressers who had been patch tested were retrospectively identified. Allergic reactions to relevant allergens from the extended European baseline series and hairdressing series were analysed against history of atopic eczema.
  
  
  RESULTS
  Of the total, 29.9% of patients had a current or past history of atopic eczema. The most frequent positive allergens from the European baseline series were nickel sulfate (32.1%) and p-phenylenediamine (19.0%) and from the hairdressing series were glyceryl monothioglycolate (21.4%) and ammonium persulfate (10.6%). There was no significant difference between people with or without a history of atopic eczema, except for fragrance mix I and nickel sulfate.
  
  
  CONCLUSIONS
  We present findings from the largest cohort of hairdressers patch tested from a single centre. It is necessary to patch test hairdressers with dermatitis, regardless of a history of atopy. Strategies to reduce prevalence of allergic contact dermatitis are required.
authors.affiliation: Department of Cutaneous Allergy, St John's Institute of Dermatology, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: O'Connell
authors.forename: Ian R
authors.initials: IR
authors.lastname: White
authors.forename: John P
authors.initials: JP
authors.lastname: Mc Fadden
authors.forename: Jonathan M L
authors.initials: JM
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects; D000645:Ammonium Sulfate / Q000009:adverse effects; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D009783:Dermatitis, Occupational / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004485:Eczema / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005989:Glycerides / Q000009:adverse effects; D006203:Hair Preparations / Q000009:adverse effects; D006229:Hand Dermatoses / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D016273:Occupational Exposure / Q000009:adverse effects*; D010328:Patch Tests; D010655:Phenylenediamines / Q000009:adverse effects; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000485:Allergens; D005989:Glycerides; D006203:Hair Preparations; D010655:Phenylenediamines; C033769:glyceryl monothioglycolate; C031276:ammonium peroxydisulfate; C029938:nickel sulfate; D009532:Nickel; D000645:Ammonium Sulfate; C029728:4-phenylenediamine