title: Prevalence of Contact Allergy to p-Phenylenediamine in the European General Population.
abstract: Population-based studies on contact allergy to p-phenylenediamine (PPD) are scarce. A cross-sectional study was performed to assess the prevalence of contact allergy to PPD and its risk factors in the general population of 5 European countries. A total of 10,425 subjects were interviewed, and a random sample (n = 2,739) was patch tested to PPD. Overall, 5,286 individuals (50.9%) reported having used hair colorants at least once in their lifetime (78% female, 20% male), and 35% had used hair colorants during the last 12 months. Hair colorant avoidance because of any skin problem during the lifetime was reported by 6%. Black henna tattoos had been used by 5.5% during their lifetime. The prevalence of PPD contact allergy was 0.8% (95% confidence interval 0.6-1.0%), with no statistically significant association with gender or hair dye use. The prevalence of PPD in black henna tattoo users was 3.2% versus 0.6% in nonusers (P < 0.001). A clinically relevant positive patch test reaction to PPD related to hair coloring products was found in 0.1% (95% confidence interval 0.0-0.2%). A significant association with PPD contact allergy was observed for subjects who had black henna tattoos in their lifetime, with an age- and gender-adjusted odds ratio of 9.33 (95% confidence interval 3.45-25.26, P < 0.001). Black henna tattoos are an important risk factor for PPD contact allergy.
authors.affiliation: Department of Social Medicine, Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany. Electronic address: thomas.diepgen@med.uni-heidelberg.de.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.affiliation: Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED-FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Naldi
authors.affiliation: Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.affiliation: Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Centro Studi GISED-FROM Presidio Ospedaliero Matteo Rota, Bergamo, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Cazzaniga
authors.affiliation: Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Schuttelaar
authors.affiliation: Department of Dermatology, University Hospital Jena, Jena, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
authors.affiliation: Department of Dermatology, Coimbra University Hospital, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Goncalo
authors.affiliation: Department of Social Medicine, Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Ofenloch
authors.affiliation: Department of Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Svensson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006202:Hair Dyes / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010328:Patch Tests / Q000379:methods; D010655:Phenylenediamines / Q000009:adverse effects / Q000276:immunology*; D015995:Prevalence; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013653:Tattooing / Q000009:adverse effects; D013997:Time Factors; D055815:Young Adult
chemical_list: D006202:Hair Dyes; D010655:Phenylenediamines; C029728:4-phenylenediamine