title: Delayed hypersensitivity reaction from black henna tattoo manifesting as severe facial swelling.
abstract: We report on a 14-year-old boy who was presented to the emergency department with an acute swelling of the face and scalp 3 days after using a new hair dye. The patient had applied a black henna tattoo 1 year earlier. Patch testing revealed an allergy to the potent skin sensitizer paraphenylenediamine, a common ingredient of hair dyes and also found in black henna tattoo. It is important for emergency physicians to be aware of the possibility of a delayed type-IV hypersensitivity reaction from black henna tattoos manifesting as an acute contact dermatitis. These patients may have gross facial swelling but should not be treated for angioedema.
authors.affiliation: Emergency Department, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel. i_shavit@rambam.health.gov.il
authors.forename: Itai
authors.initials: I
authors.lastname: Shavit
authors.forename: Yoav
authors.initials: Y
authors.lastname: Hoffmann
authors.forename: Yael
authors.initials: Y
authors.lastname: Shachor-Meyouhas
authors.forename: Hadas
authors.initials: H
authors.lastname: Knaani-Levinz
mesh_terms: D000293:Adolescent; D004396:Coloring Agents / Q000009:adverse effects*; D004487:Edema / Q000276:immunology*; D005145:Face; D006202:Hair Dyes / Q000009:adverse effects; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D008297:Male; D009285:Naphthoquinones / Q000009:adverse effects*; D010655:Phenylenediamines / Q000009:adverse effects*
chemical_list: D004396:Coloring Agents; D006202:Hair Dyes; D009285:Naphthoquinones; D010655:Phenylenediamines; C005090:lawsone; C029728:4-phenylenediamine