The clinical spectrum of reactions developed based on paraphenylenediamine hypersensitivity two pediatric cases

Paraphenylenediamine (PPD) is a blue-black aniline dye commonly used in hair dyes. It is also used in textile and fur dyes, wool dye, dark cosmetics, temporary tattoo hennas, photo baths, and photocopy and printing ink. Paraphenylenediamine, which accelerates the absorption of hair dye and henna tattoos by the skin and helps the formation of the black color, is an allergen. Paraphenylenediamine leads to hypersensitivity reactions, involving allergic and irritant contact dermatitis [1–3]. Since tattoo and hair dyes are now frequently used in younger children, complications of these applications (which are considered harmless and temporary) are appearing in children. In this study, two pediatric patients who presented to our department with clinical symptoms similar to angioedema and allergic contact dermatitis are discussed.
Case 1: A 9-year-old boy presented with redness, itching, swelling and burning sensation in his right arm. In the preliminary case history, he stated he had received a temporary tattoo performed with Indian henna on his right arm 3 days before. There was no atopy history of either the patient or his family. He had no systemic or dermatological illnesses. On the dermatological examination, erythematous and edematous papulonodular plaques in the tattooed area of the right arm were observed (Figure 1 A). Other systemic findings and laboratory tests were within normal limits. He was diagnosed with allergic contact dermatitis based on the temporary Indian henna tattoo and prescribed topical corticosteroid for 5 days and oral desloratadine 5 mg/day for 5 days. The lesions improved without sequelae within a short period of time (Figure 1 B).
Case 2:A 14-year-old girl presented to our clinic with edematous eyes, and redness and swelling in the scalp and nape area. The patient reported that she had not used any new cosmetic products or medicines for the area in which lesions were located; however, she had her hair dyed only 2 days before the complaints started. She had no atopy and no chronic skin disease in her preliminary case history, but it was discovered that the redness and itching developed after she had received a temporary Indian henna tattoo on her arm 2 months before. On the physical examination, hyperemia and edema were observed on her face and swelling that could have been angioedema in her both eyelids (Figure 2 A). Hyperemia and edema were diagnosed in her scalp and nape area. She had no respiratory problems. Other...


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