p-Phenylenediamine in Black Henna Tattoos

Jacob, Sharon E.; Zapolanski, Tamar; Chayavichitsilp, Pamela; Connelly, Elizabeth Alvarez; Eichenfield, Lawrence F.

doi:10.1001/archpedi.162.8.790

Cited by 27 publications

(2 citation statements)

References 26 publications

(25 reference statements)

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“…In the United States, the law does not permit the import of temporary tattoos containing PPD; therefore, the use of black henna is considered illegal; similar directives have also been applied in other countries, such as Canada, New Zealand and Australia [ 39 ]. However, in European countries, there are no definitive statements that regulate the practice of henna tattoo application, making difficult to monitor the distribution of these products and to regulate tattoo artists who practice on beaches and in markets, fairs and amusement parks.…”

Section: Discussionmentioning

confidence: 99%

Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature

Panfili

Esposito

Cara

2017

IJERPH

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Background: The use of temporary henna tattoos has increased dramatically in recent years, especially in children and adolescents. To obtain a darker colour and prolong the life of the tattoo, red henna, a plant-derived substance, is typically added to para-phenylenediamine (PPD). The mixture is called temporary black henna tattoo (TBHT). Because of its molecular characteristics, PPD can induce skin sensitization that may cause various clinical manifestations with successive exposures, among which the most common is allergic contact dermatitis (ACD). This report describes two paediatric cases of PPD sensitization and ACD after the exposure to TBHT and summarizes the literature on this emerging clinical problem. Case Presentation: We describe two cases of childhood-onset ACD that occurred 2 and 10 days, respectively, after the application of a TBHT during the summer holidays. Patch tests showed an evident positive response to 1% PPD in both cases. Sensitization to PPD occurred in the first case because a previous henna tattoo did not result in overt symptoms; in the second case, the reaction occurred after the same tattoo was retouched. In both cases, hypopigmentation persisted and both the patients and their families were advised to avoid further contact with PPD-containing materials and substances that could lead to cross-reactions. Conclusions: Sensitization to PPD is a growing phenomenon in children. The most common cause appears to be exposure to TBHT in which PPD might be present at unknown or high concentrations. Once sensitization occurs, patients may experience severe clinical symptoms which can present with a persistent hypopigmentation when they are re-exposed to substances that contain or cross-react with PPD. Given the widespread use of PPD, TBHT could adversely affect the daily life of paediatric patients; thus, for this reason, this practice as a fashion accessory must be discouraged. In addition, it is extremely important to provide scientific information on the risks of TBHT to consumers, especially to adolescents and to the parents of younger children to prevent PPD sensitization.

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Section: Discussionmentioning

confidence: 99%

Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature

Panfili

Esposito

Cara

2017

IJERPH

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“…[8] Exposure to it in hair dye products may cause severe facial edema and acute dermatitis. It has been reported to cause contact dermatitis followed by EM in sensitized patient.…”

Section: Discussionmentioning

confidence: 99%

Erythema multiforme following application of hair dye

Koley

Sarkar

Choudhary³

et al. 2012

Indian J Dermatol

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Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction with varying degrees of blistering and ulceration. Common causes of EM are herpes simplex virus infection, mycoplasma infection, drug hypersensitivity, vaccination and drug–virus interaction. EM induced by contact dermatitis is rare. Paraphenylene diamine, a common ingredient in many hair dyes, is well known to produce allergic contact dermatitis. We report a 35-year-old lady presenting with EM following severe contact dermatitis to hair dye. So far as we know, this is the first report from India describing EM following contact dermatitis.

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