Padovan et al., in their studies on hypersensitivity to beta-lactams antibiotics, reported that Th1 profile, very common in contact allergy, may shift to a Th2 profile depending on the hapten concentration [72]. Reports are also now appearing from tattoos applied in Europe and the USA. Immunopharmacol Immunotoxicol. Ballard MS. 2000;41:16871. There have been more than 140 reported cases in English language literature and this illustrates the burden of allergic dermatitis due to PPD.14 There have been reports of tattoo-induced chronic psoriasis on the tattoo sites despite treatment.15. On physical examination, the area of the tattoo was red and swollen. General practitioners (GPs) should educate potential users to avoid using henna products with PPD additives and to instead use natural henna. and transmitted securely. In someone already sensitised to PPD due to earlier exposure to the chemical, the reaction develops within 48 hours. Minimise the risk of subsequent exposure to other sources of PPD(particularly permanent hair dye) and chemically related compounds once sensitisation has occurred. 1999;162:11717. California Privacy Statement, Paraphenyldiamine (PPD) in addition to its systemic toxicity not only exposes to a selective allergy to (PPD) but also to several of these derivatives and metabolites with cross reactions. The Royal Australian College of General Practitioners, 100 Wellington Parade, East Melbourne, Victoria 3002, Australia. volume15, Articlenumber:8 (2017) Shavit I, Hoffmann Y, Shachor-Meyouhas Y, Knaani-Levinz H. Delayed hypersensitivity reaction from black henna tattoo manifesting as severe facial swelling. The tattooing procedures have been quite variable in different ages, depending on the cultures involved and thus influencing the perception of a positive or a negative significance. Liquid modernity. 2014;53:34850. Sosted H, Johanssen JD, Andersen KE, Menn T. Severe allergic hair dye reaction in 8 children. Clinical and Molecular Allergy Requests for permission to reprint articles must be sent to permissions@racgp.org.au. Int J Dermatol 2009;48:97983. will also be available for a limited time. Author: Dr Delwyn Dyall-Smith FACD, Dermatologist, Australia in 2011. Accessibility suggested that patients sensitized to black henna tattoo should be divided into 2 groups according to their clinical course, that may be acute or subacute. Treatment generally involves the use of topical corticosteroids. Natural pure henna does not cause allergic reactions. DermNet NZ does not provide an online consultation service. Article Choovichian V, Chatapat L, Piyaphanee W. A Bubble Turtle: bullous contact dermatitis after a black henna tattoo in a backpacker in Thailand. Thus, the clinical features define 2 groups: an acute response to temporary tattooing, typically presenting with intense eczematous responses within 12days of tattooing, and a subacute response, that is, developing lichenoid eruptions slowly in 12weeks [11]. Lythraceae. Henna is a naturally occurring brown dye made from the leaves of the tree Lawsonia inermis. that are added to henna mixtures. Side-effects of henna and semi-permanent black henna tattoos: a full review. de Groot AC. Contact dermatitis after henna skin tattooing. Black henna tattoo reaction. Many of the reported cases of henna tattooing dermatitis involve European tourists who visited the Middle-East or people with fair skin who had paint-on tattoos done by street or beach artists. Also, henna has been used as a brown dye for wool, cotton, and silk [3]. There was no reaction at the vinegar site (Fig. Natural substances such as lemon oil, vinegar, and eucalyptus oil are added to obtain different shades [5]. Clinicopathologic features of skin reactions to temporary tattoos and analysis of possible causes. PubMed Due to implications of PPD reaction on the immune system and possible renal complication, the patient was investigated for complete blood count, creatinine level, eGFR and electrolytes. elaborated the pharmacological-immune interaction concept (p-i concept) as they found that some drugs like sulfamethoxazole and lidocaine can bind directly to the HLA peptide complex stimulating T lymphocytes through an HLA restricted processing and metabolism independent pathway [73]. The literature underlines that different clinical manifestations are related to black henna containing PPD, and its derivative products may cause delayed-type as well as immediate-type reactions. J Allergy Clin Immunol. UV radiation-induced chemical changes, provoking an allergic skin reaction, can result not only from topical application to the skin. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 2008;26:515e34. A retrospective review of the Pitchbook Database, Milia en plaque manifesting as a post-herpetic isotopic response. Various substances, such as lemon oil, vinegar, eucalyptus oil and coffee, may be added to obtain different colouring effects and a thick paste [4]. Contact Dermat. CI participated in coordination and helped to draft the manuscript. Solis RR, Dotson DA, Trizna Z. Phytophotodermatitis, a sometimes difficult diagnosis. Int J Environ Res Public Health. DermNet NZ does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. Often kerosene or petrol is also added to improve the uptake of the colour. An individuals encounter or experience will have a domino and contagious effect to other members in a community.21 It is an effective strategy of engagement between the GP and members of the community. It is a woody shrub, reaching heights up to 3 metres, which grows up mainly in the warm, moist regions of North Africa, South Asia, India and Sri Lanka. 1998;10:50715. November 2019. a nonspecific irritant effect or may cause a chemical change in the henna such that it is more allergenic. The Fadden et al. 2003;48:3012. Allergic contact dermatitis The long-term management goal is to identify and eliminate the offending agents, educate the patient to read the packaging of dyes and avoidance of those containing any PPD chemicals such as black henna and hair dyes. 2006;28:438. Kazandjieva J, Grozdev I, Tsankov N. Temporary henna tattoos. Australas J Dermatol. 2005;54:21920. Pegas JR, Criado PR, Criado RF, Vasconcellos C, Pires MC. 2015;22:2878. The other sources of exposure include black henna tattoos, leather, fur, textiles and rubber products.5 The majority of positive patch testing is due to reaction to PPD while natural henna does not show any positive reactivity.6,7 PPD can cross-react with para-amino compounds (benzocaine, sulfa drugs, aminoazobenzene, IPPD, PABA) and hairdressing allergens (2,5-diaminotoluene sulfate, 2-Nitro-4-phenylenediamine, 4-aminophenol, 3-aminophenol). Padovan E, von Greyerz S, Pichler WJ, Weltzien HU. Br J Dermatol. The potential users in our case are from East African communities (Somalis, Eritreans, Ethiopians, Sudanese) who use it occasionally during celebratory occasions such as Eid celebrations, marriage and parturient festivities. Miulli Hospital, Acquaviva delle Fonti, Bari, Italy, Department of Pediatrics, University of California Davis School of Medicine, Sacramento, USA, Allergy Outpatients Clinic, ASL-TO3, Ospedale Civile E. 2009;15:15. 2015;32:1912. 2014;25:912. Lopez IE, Turrentine JE, Cruz PD. Anaphylaxis to hair dye: a case report. From January 2018, it was superseded by AJGP: Australian Journal of General Practice, The Royal Australian College of General Practitioners 2021. Painless, highly decorative and, above all, temporary, the henna colour lasts for up to 3weeks, making it is the perfect way of creating a fashionable look while avoiding the consequences or risks connected to a permanent tattoo. This is an acute, severe and even life-threatening condition, sometimes requiring an admission in an Intensive Care Unit [25, 28, 29], because of the involvement of the upper airways frequently in young patients [30,31,32]. Br J Dermatol. We present a case of this irreflected practice. Pediatr Dermatol. 2014;31:3224. Every care is taken to reproduce articles accurately, but the publisher accepts no responsibility for errors, omissions or inaccuracies contained therein or for the consequences of any action taken by any person as a result of anything contained in this publication. CAS He did not have any chronic medical condition and no known allergies. The incidence of positive patch testing could be high among the community, which warrants further studies to help in the management of allergic dermatitis. This allergy will persist throughout life with daily consequences and a possibility of cross-reactions to products containing (PPD) or one of its derivatives, which explains that the person become allergic to avoid contact with many products, with a considerable impact on its quality of life. It is traditionally used in Islamic and Hindu 1992;12:36. Contact Dermat. The authors do not declare any conflict of interest for this work. Pneumology and Allergy Department, Hospital Sacro Cuore, Gallipoli, Lecce, Italy, Section of Allergy and Clinical Immunology, Unit of Internal Medicine-F. BL revised the manuscript. The compound PPD in hair dye is implicated as the main culprit for allergic dermatitis. Tukenmez Demirci G, Kivanc Altunay I, Atis G, Kucukunal A. Allergic contact dermatitis mimicking angioedema due to paraphenylenediamine hypersensitivity: a case report. It has a religious and social significance [3]. Semin Cutan Med Surg 2009;28:7785. Contact Dermat. Dermatitis. Worsnop FS, Craythorne EE, du Vivier AW. As far as allergic reactions are concerned [5, 6], the pure henna is a weak sensitizer and it is poorly responsible for allergic contact dermatitis [7,8,9], but when para-phenylenediamine (PPD), that is a strong sensitizing agent, is added the frequency of allergic reactions increases. had previously reported that the oxidation product of PPD causing the immediate-type reaction is NN-bis(4-aminophenyl)-2,5-diamino-1,4-quinone-dimine [69], also known as Brandowski base (BB), although they were unable to produce a suitable RAST assay [69]. Systemic medications such as diuretics (hydrochlorothiazide, furosamide), antibiotics (tetracyclines, fluorquinolones, sulfonamides), chlorpromazine and nonsteroidal anti-inflammatory drugs may induce similar reaction.9 However, in this case, skin reaction will involve all sun exposed areas. We reviewed the various clinical patterns related to PPD and henna tattoo to investigate the possible link between clinic-morphological pictures and the immunological response to PPD and henna. The henna is left on the skin to dry for at least 2h and preferably up to 24h. The longer henna is put in contact with the skin, the darker the resulting colour will be [3]. Para-phenylenediamine-induced lichenoid eruptions. Bauman Z. Schnuch A, Lessmann H, Frosch PJ, Uter W. Para-Phenylenediamine: the profile of an important allegens. Pasche-Koo E, French L, Piletta-Zanin PA, Hauser C. Contact urticarial and shock to hair dye. J Allergy Clin Immunol. The most notorious agent is PPD. 2007;176:4456. Broides A, Sofer S, Lazar I. PubMed Central Contact Dermat. Cambridge: Polity Press; 2000. Hueber-Becker F, Nohyneck G, Meuling W, Beneech-Keffer F, Toutain H. Human systemic exposure to a 14-C-paraphenylenediamine containing oxidative hair dye and correlation with in vitro percutaneous absorption in human or pig skin. It has been suggested, from experimental studies on animals, that specific T-cells with a Th2 cytokines pattern profile specific to PPD could be the effectors cells of delayed response [71]. Sahoo B, Handa S, Penchalla K, Kumab H. Contact anaphylaxis due to hair dye. Cite this article. we report a case of allergic contact dermatitis from pure henna that is also used for the relief of rheumatic pain. 2001;56:248. It was left there for 6 hours in order to relieve the joint pain. 1996;348:658. 2010;94:64564. 2012;148:1299301. 2004;42:122736. The henna page. Allergic contact dermatitis to paraphenylenediamine in temporary henna tattoo. The diagnosis of black henna tattoo reaction is usually made on the history and clinical appearance. This was reported also in mice, because PPD-HSA causes a transient activation of CD8+cytotoxic cells only [63]. Of particular interesting social behavior among certain communities is that of a herding phenomenon. 2013;69:125. The area was exposed to sunlight. Semwal RB, Semwal DK, Combrinck S, Cartwright-Jones C, Viljoen A. Lawsonia inermis L. (henna): ethnobotanical, phytochemical and pharmacological aspects. Jenkinson C, Jenkins R, Aleksic M, Pirmoahamed M, Naisbit D, Park BK. 2003;132:38592. Paraphenylenediamine induced acute tubular necrosis following hair dye ingestion. Keloid scarring has been reported. Int J Dermatol. 2), probably due to delayed hypersensitivity, and a stronger reaction to natural Intermittent exposure to low concentration paraphenylenediamine can be equivalent to single higher-dose exposure. Here we review the various clinical patterns related to PPD and henna tattoo, to investigate the possible link between clinic-morphological pictures and the immunological response to PPD and henna. Br J Dermatol 2008;159:37086. This classification was based on the previous studies of Buckley on photographers [11]. These additives include agents such as daiminotoluenes and diaminobenzenes. There is a growing community of East African people in these regions. Books about skin diseasesBooks about the skin Pigmentation 2 weeks' later. Int Immunol. J Ethnopharmacol. Henna (Lawsonia inermis) is part of the family Lythraceae, best known as a source of natural dyes. Henna is one of these plants and is used especially for mycotic We can educate and counsel this community during a brief clinical visit and in new comers centres in Canada. Generally, the first signs of allergic contact dermatitis caused by black henna tattoos develop within 13days in those already sensitized, and within 414days in patients who become sensitized by the tattoo [5]. By continuing to use this website, you agree to our Terms of Use | Privacy Policy. The diagnosis of contact dermatitis to black henna mixed with para-phenyldiamine (PPD) was discussed and withheld. Brown JH, Conway B, Hill CM. Contact allergen of the year: paraphenylenediamine. The ever-increasing number of awareness cases (PPD) and the serious consequences for the quality of life of the patient justify the urgent need for public awareness and regulation of its use. Cutaneous B-cell pseudolymphoma due to paraphenylenediamine. Goldberg et al. Polat M, Dikilita M, Ozta P, Alli N. Allergic contact dermatitis to pure henna. Contact dermatitis with severe scalp swelling and upper airway compromise due to black henna hair dye. Abdullah K, McDavidson N. A woman who collapsed after painting her soles. Nacaroglu HT, Celegen M, Karkner CS, Gnay I, Diniz G, Can D. Eosinophilic cellulitis (Wells syndrome) caused by a temporary henna tattoo. Black henna temporary tattoo. Moreover, henna has great significance in all Eastern wedding traditions, and no wedding is complete without drawing floral motifs or geometric decorations on the brides hands and feet. White mark 2 weeks' later Open Access Publications from the University of California, Allergic contact dermatitis to pure henna, Utility of an anonymous online interactive forum for dermatology residency program directors and applicants, Educational attainment is inversely correlated with hidradenitis suppurativa severity, Post ambulatory swollen hands (POTASH) revisited: post ambulatory hand swelling in a half marathon participant, Innovation in dermatology: where are the dermatologists? Carroll J, Epstein R, Fiscella K, Volpe E, Diaz K, Omar S. Knowledge and beliefs about health promotion and preventive health care among somali women in the United States. Hum Toxicol. The https:// ensures that you are connecting to the Red henna temporary tattoo Fatalities with the use of henna dye. Google Scholar. We recommend avoiding exposure to temporary paint-on black henna tattoos, because of the high risk of sensitisation. LaBerge L, Pratt M, Fong B, Gavigan G. A 10-year review of p-phenylenediamine allergy and related para-amino compounds at the Ottawa Patch Test Clinic. sharing sensitive information, make sure youre on a federal Redlick F, DeKoven J. Allergic contact dermatitis to paraphenylenediamine in hair dye after sensitization from black henna tattoos: a report of 6 cases. DeLeo VA. Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism? It is a woody shrub that grow in regions of North Africa, South Asia, India and Sri Lanka. Dermatitis Google Scholar. Al Suwaidi A, Ahmed H. Determination of paraphenylenediamine (PPD) in henna in the United Arab Emirates. Delayed type hypersensitivity reaction to para-phenylenediamine is mediated by 2 different pathways of antigen recognition by specific alpha/beta human T cell clones. Ann Occup Hyg 2010:54:45358. Some in vitro studies have confirmed that such immunological model is working not only for drugs, but even for some contact allergen like PPD [74]. Paley K, Geskin LJ, Zirwas MJ. study on patch testing reaction in Ethiopian subjects with previous eczema reveals that more than 60% of subjects were positive to many allergens.8 The use of temporary tattoos in Copenhagen, Denmark, among trained hairdressers and the general population is 39.4% and 33.3% respectively and the incidence of allergic reaction could be as high as 2.3% among people who had a tattoo.9, The dermatological manifestation of allergic dermatitis to PPD varies in severity from an intensely itchy erythematous, blistering eruption to painful, itchy exudative bullous eruptions, face and scalp swelling, or renal collapse and failure;1013 Black henna allergic dermatitis is an ongoing problem with an extensive surge of cases, which pinpoint the culprit to a history of hair dye exposure. EDL was the co-contributor in writing the manuscript. natural henna mixed with vinegar, and vinegar only. The use of henna tattooing has become popular beyond its traditional boundaries. Med Clin North Am. Actually, no specific IgE to PPD or any related oxidative product have been identified in vitro, but it has been demonstrated that a radio-labelled PPD containing oxidative hair dye applied to human volunteers for 30min is eliminated predominantly (8090%) by renal excretion, being accumulated in urine [68]. arrow-right-small-blue 1995;131:54451. Manage cookies/Do not sell my data we use in the preference centre.
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