Severe type IV hypersensitivity to 'black henna' tattoo.
A 16-year-old Bangladeshi girl presented with a 9-day history of an extensive pruritic, erythematous, papulovesicular skin eruption to both forearms. Appearance was 5 days following application of a home-made henna preparation. Examination revealed ulceration and scabbing along the whole henna pattern and early keloid formation. A diagnosis of type IV delayed hypersensitivity reaction superimposed by infection was initially made. As in this case, home-made henna preparations commonly combine commercial henna with black hair dye, paraphenylenediamine (PPD). PPD, widely known as 'black henna', darkens the pigment and precipitates the drying process. PPD is a potent contact allergen associated with a high incidence of hypersensitivity reactions. Despite treatment the patient was left with extensive keloid scarring in the pattern of the henna tattoo.
Department of Acute Medicine, St Bartholomew's and The Royal London Hospitals, UK.
Vasileios
V
Vasilakis
Bernice
B
Knight
Satnam
S
Lidder
Sarah
S
Frankton
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D004396:Coloring Agents / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D031564:Lawsonia Plant / Q000009:adverse effects*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013653:Tattooing / Q000009:adverse effects*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D004396:Coloring Agents