title: Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism?
abstract: Hypersensitivity to para-phenylenediamine (PPD) and related compounds induced by temporary black henna tattoos has become a serious health problem worldwide. Different patterns of sensitization with various clinical aspects are described in literature due to PPD associated to henna tattoo and these manifestations are likely correlated with the immunological and dermatological pathomechanisms involved. Henna is the Persian name of the plantLawsonia inermis,Fam.Lythraceae. It is a woody shrub that grow in regions of North Africa, South Asia, India and Sri Lanka. Nowadays it is rather frequent to see temporary "tattoos" performed with henna. To make tattoos darker and long-lasting PPD has been associated to henna in tattoo drawings mixtures, so obtaining "black henna". In these years there has been a rise of contact sensitization to PPD and in medical literature an increased number of cases have been reported on temporary henna tattoo application. 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. 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. Further studies are needed to investigate the relationship between clinical and morphological aspects of PPD contact dermatitis and the T cell subsets predominance.
authors.affiliation: Pneumology and Allergy Department, Hospital Sacro Cuore, Gallipoli, Lecce, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Calogiuri
authors.affiliation: Section of Allergy and Clinical Immunology, Unit of Internal Medicine-"F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Di Leo
authors.affiliation: Department of Pediatrics, University of California Davis School of Medicine, Sacramento, USA.
authors.forename: Lavjay
authors.initials: L
authors.lastname: Butani
authors.affiliation: Allergy Outpatients' Clinic, ASL-TO3, Ospedale Civile "E. Agnelli", Pinerolo, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pizzimenti
authors.affiliation: ASST Specialistic Center Gaetano Pini/CTO, Milan, Italy.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Macchia
authors.affiliation: Section of Allergy and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors.forename: Eustachio
authors.initials: E
authors.lastname: Nettis
keywords: Allergy; Black henna; Contact dermatitis; Henna tattoo; Para-phenylenediamine