In addition to the Japanese baseline allergen series version 2008,11 we used cysteamine HCl 1% and 0.5% pet. (Table S1). We also included the participants' own perming solutions, as used by them at the salon, for open tests.
RESULTSDetails of the 3 male and 4 female hairdressers, ranging in age from 22 to 73 years, are shown in Table S2. Regarding the cysteamine HCl patch tests, 5 patients showed positive reactions to both 1% and 0.5%. One patient showed a positive reaction to 1% alone, and the other patient, who had a positive reaction to 0.5%, had not been tested with 1% (Table 1). The results of the open test showed that, among 6 patients tested with the reducing agent of the permanent wave products, 5 showed erythema, partly oedema, or papules. Moreover, 6 patients also showed strong positive reactions to components of oxidative hair dye products and related substances. On the other hand, none of the 7 patients showed a positive reaction to ammonium thioglycolate.
DISCUSSIONThe active chemicals used to create permanent waves are salts and esters of thioglycolic acid, L-cysteine, and cysteamine HCl. Contact dermatitis caused by cysteamine HCl is reportedly rare, and all cases were related to occupational use. 8,9 On the other hand, Tanita et al reported that 18.8% of 48 hairdressers showed positive patch test reactions to cysteamine 1% pet.in Japan. 12 In a Japanese multicentre study, 10 4.5% of patients (6/132) showed positive patch test reactions to cysteamine HCl 0.5% pet., and 12.6% (24/191) showed positive patch test reactions to cysteamine HCl 1% pet. Although 1% cysteamine HCl had exclusively been used for patch testing, the multicentre study showed that 1% cysteamine HCl may cause false-positive reactions, so a 0.5% concentration was regarded as being more suitable. 10