Abstract
The use of hair dye has been emerging worldwide however usage of Paraphenylenediamine (PPD) in making hair dye is generally restricted to underdeveloped and developing countries. In particular, prevalence of accidental and suicidal ingestion is more in low socioeconomic areas. The spectra of hair dye toxicity is wide, however, it presents more commonly with severe angioedema of face and neck leading to respiratory failure, rhabdomyolysis complicating into acute kidney injury, myocarditis and acute liver injury. Here we present a unique case of PPD poisoning in a young female presented with laryngeal edema and marked rhabdomyolysis. Preemptive shifting to Critical care unit and elective endotracheal intubation for air way patency obviated the need of tracheostomy and precluded its related complications. Moreover, aggressive intravenous hydration prevented from renal failure despite markedly raised Creatine phospho kinase (CPK) levels.
Highlights
Hair Dye Poisoning is highly uncommon in western world due to strict formulary regulations, it is emerging as a common means of suicide in developing world Africa and Asia.[1]
One of the cheapest forms of chemical used for making hair dye and Henna is taken from black stone regionally known as “kalapathar”
Most cases of hair dye poisoning occur with suicidal intentions more common in young age females.[9]
Summary
Hair Dye Poisoning is highly uncommon in western world due to strict formulary regulations, it is emerging as a common means of suicide in developing world Africa and Asia.[1]. Hair dye powder is readily available and its widespread usage in this part of the world makes it imperative to understand the clinical implications of its toxicity whether suicidal or accidental This is rather an under reported and under documented problem in Pakistan. 15/0.8 97,628 ml-200ml of hair dye, six hours prior to presentation with suicidal intentions On examination her pulse rate was 105 beats /minute, respiratory rate of 38 breaths/minute, blood pressure of 148/90 mmHg, with SpO2 of 95% at room air. She had a facial swelling extending up to the neck with mild stridor. Day-4, she showed signs of improvement in laryngeal edema and CPK levels started waning off. Patient was discharged on Day-7 with no residual deficit
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