Images in Clinical Medicine
Allergic Contact Dermatitis from a Henna Tattoo
N Engl J Med 2008; 359:627August 7, 2008
- Article
A 19-year-old otherwise healthy Kuwaiti woman presented 8 days after the brush application of a temporary henna tattoo while in Kuwait for a wedding. Burning and itching at the site of application began 6 days after the application, indicating that the reaction was more likely caused by an allergen than by an irritant; these symptoms were followed 1 day later by a vigorous blistering reaction (Panel A). Examination revealed tense bullae without surrounding inflammation in a geometric pattern that strictly mirrored the sites of application (Panel B). Temporary henna tattooing is a custom at weddings in much of the world. The dyeing agent (hennotannic acid) rarely leads to skin sensitization. However, tattoo henna is often mixed with paraphenylenediamine (PPD) to hasten drying and darken the color. PPD is a common allergen that is also found in permanent hair dyes. Allergens that cause reactions in patients who are sensitive to PPD include sunscreens containing aminobenzoic acid, certain local anesthetics, and sulfonamides. The patient was treated with high-potency topical corticosteroids, and the lesions resolved, although with extensive postinflammatory hyperpigmentation.
Colby C. Evans, M.D.
John D. Fleming, M.B., B.S.
St. John's Institute of Dermatology, London SE1 7EH, United Kingdom
colbyevans@hotmail.com - Citing Articles (2)
Citing Articles
1
Gulsen Tukenmez Demirci, Ilknur Kivanc Altunay, Guldehan Atis, Asli Kucukunal. (2011) Allergic contact dermatitis mimicking angioedema due to paraphenylendiamine hypersensitivity: a case report. Cutaneous and Ocular Toxicology1-3
CrossRef2
Manfred Kneilling, Ulrich Caroli, Cornelia Grimmel, Jörg Fischer, Martin Eichner, Thomas Wieder, Florian C. Maier, Martin Röcken, Tilo Biedermann. (2010) Para- phenylenediamine-specific lymphocyte activation test: a sensitive in vitro assay to detect para- phenylenediamine sensitization in patients with severe allergic reactions. Experimental Dermatology 19:5, 435-441
CrossRef
