Temporary Black Henna Tattoos Research Articles

Allergic Contact Dermatitis to Temporary Black Henna Tattoo Due to Sensitization to Para-Phenylenediamine

The fashion for temporary “black henna tattoo” is becoming increasingly more common among young adults and teens. An adolescent case with itching, erythema, edema, and inflammatory discharge on the right forearm two days after a temporary tattoo application is presented in this report. To determine the contact sensitizer, a patch test was performed one month after the end of the treatment. A bullous strong positive reaction (3+) was observed against para-phenylenediamine at the 48th and 72nd hours of evaluation after the application. Despite the common belief that henna tattoo application is harmless, the ingredients used in henna tattoo especially para-phenylenediamine can lead to allergenic reactions that can even be severe.Keywords: Adolescent, contact dermatitis, para-phenylenediamine

Dermatology Clinical Case

Herein are reported two cases of a previously healthy fourteen-year-old girl and a nine-year-old boy who presented to the Pediatric Emergency Department with a cutaneous reaction after applying a temporary black henna tattoo. Diagnosis of delayed hypersensitivity to black henna was established. Black henna tattoos are known for their temporary and harmless nature, but henna usually contains paraphenylendamine (PPD), originating black henna. PPD induces skin sensitization and causes allergic contact dermatitis.

IL-24 contributes to skin inflammation in Para-Phenylenediamine-induced contact hypersensitivity

Para-Phenylenediamine (PPD) is an aromatic amine used in hair dyes and in temporary black henna tattoos, which is a frequent cause of allergic contact dermatitis (ACD). ACD is a skin inflammatory reaction characterized by modifications such as spongiosis, exocytosis and acanthosis. The aim of this study is to characterize the expression and the role of IL-20-related cytokines, including IL-19, IL-20, IL-22 and IL-24, in ACD. The expression of IL19, IL20, IL22 and IL24 is increased in affected skin from PPD allergic patients compared with uninvolved skin. In addition, the expression of these cytokines positively correlates with clinical symptoms. To assess their role in ACD, we set up a mouse model of PPD-induced allergic contact dermatitis and we showed that, in contrast to Il22-deficient mice, Il22ra1-, Il20rb- and Il24-deficient mice are partially protected against development of PPD-induced contact hypersensitivity. These mice have decreased ear thickening and less acanthosis compared with WT mice after PPD treatment. In addition, the absence of IL-22R, IL-20R2 or IL-24 affects the recruitment of neutrophils into the skin but not the total IgE production. Taken together, these results demonstrate the implication of IL-24 via the IL-20R type II receptor in the inflammatory process of ACD.

Factors associated with p-phenylenediamine sensitization: data from the Information Network of Departments of Dermatology, 2008-2013.

Risk factors for p-phenylenediamine (PPD) sensitization include the use of hair dyes, the application of temporary black henna tattoos, working as a hairdresser, and, possibly, exposure to hair dye pretests. To quantify the impact of these (putative) risk factors on PPD sensitization. Six items related to PPD exposure were added to the routine Information Network of Departments of Dermatology questionnaire from 2008 to 2013. A retrospective analysis of data from 4314 patients tested with PPD 1% pet. was conducted. Of the PPD-positive patients (n = 271), 80% had their hair dyed, and, of these, 57% subsequently developed scalp dermatitis, whereas only 11% had had a henna tattoo. The self-administrated pretest with hair dye was performed by only a few patients, precluding a more detailed analysis. Hair dyeing [odds ratio (OR) 6.0; 95% confidence interval (CI): 3.9-9.4], henna tattoos (OR 2.4; 95%CI: 1.5-3.7) and being a hairdresser (OR 2.1; 95%CI: 1.3-3.2) increased the risk of PPD sensitization. Neither dyeing of own hair nor application of a temporary henna tattoo seemed to affect PPD sensitization in hairdressers. p-Aminoaryl compounds more often gave positive reactions in patients with henna tattoo. Hair dyeing is the major risk factor for PPD sensitization in this clinical setting, and application of a temporary black henna tattoo may also lead to (strong) PPD sensitization.

Monitoring of Lawsone, p-phenylenediamine and heavy metals in commercial temporary black henna tattoos sold in Turkey.

Henna has a very low allergic potential, and severe allergenic contact dermatitis is mainly caused by p-phenylenediamine (PPD), which is added to temporary black 'henna tattoos', and potentially also by some heavy metals. To determine the presence of, and quantify, Lawsone, PPD and heavy metal contaminants (cobalt, nickel, lead, and chromium) in commercial temporary black henna tattoo mixtures (n = 25) sold in Turkey. Lawsone and PPD concentrations were analysed with high-performance liquid chromatography, and heavy metal quantification was performed with inductively coupled plasma mass spectrometry. PPD was found in all 25 black henna tattoo samples purchased from tattoo shops; levels varied between 3.37% and 51.6%. Lawsone was detected (0.002-88.2%) in 21 of the 25 temporary black henna tattoo samples analysed. Heavy metal contaminant levels were 0.44-3.11 ppm for Co, 1.13-2.20 ppm for Ni, 1.59-17.7 ppm for Pb, and 35.0-76.9 ppm for Cr. Our results suggest that commercial temporary black henna mixtures containing PPD levels up to 51.6% pose a risk of contact sensitization and severe allergic contact dermatitis among users. It is important to identify both the additives and metallic contaminants of black henna tattoo products; the significance of metal contaminants has still to be assessed.

Hypertrichosis due to black henna tattoo treated with 755 nm Alexandrite Laser

Henna is the powdered leaf of Lawsonia Inermis, and has been widely used as a dye for the skin, hair and nails. Black henna is composed of henna itself with p-phenylenediamine (PPD) and used for temporary black henna tattoos. The PPD compound of the henna transforms the harmless henna to an allergenic material and generalized erythema multiforme, Sweet’s syndrome, acquired leucoderma, urticaria and angioneurotic edema are the other reported rare complications of black henna tattoos. Localized hypertrichosis on the temporary henna tattoo is not a usual side effect and there are a few reports about this topic. The common point of these cases is disappearance of the hypertrichosis within 4-5 months. Notwithstanding the fact that the treatment is not certainly necessary, it could be a problem for some patients because of its cosmetic concern. This case is an example of localized hypertrichosis after henna tattoo and treated immediately with 755 nm Alexandrite Laser in one session.

ID: 199: Expression of IL-20-related cytokines in PPD-induced allergic contact dermatitis and their role in a mouse model

Para-Phenylenediamine (PPD) is an aromatic amine used in hair dyes and in temporary black henna tattoos, which is a frequent cause of allergic contact dermatitis (ACD). ACD is a skin inflammatory disease characterized by modifications such as spongiosis, exocytosis and acanthosis. The aim of this study is to characterize the expression and the role of IL-20-related cytokines, including IL-19, IL-20, IL-22 and IL-24, in ACD. In 11 patients with a history of positive patch-test reaction to PPD, patch tests with PPD 1% in petrolatum were applied and skin biopsies were performed after 8, 24 and 48 h. The mRNA level of IL-20-related cytokines is increased in affected vs uninvolved skin from PPD allergic patients (positive patch test to PPD). In order to assess the role of these cytokines, we set up a mouse model of PPD-induced allergic contact dermatitis and we showed that IL-22R−/− or IL-20R2−/− mice are partially protected against development of PPD-induced contact hypersensitivity. These mice presented a lower ear thickening than WT treated mice. This was confirmed at histological level, because, after PPD treatment, IL-22R−/− mice showed less acanthosis than WT mice. In addition, we showed that IL-22R plays a role in induction of chemokine expression as well as neutrophil marker. Along the same line, after PPD treatment, proportion of neutrophils is lower in the skin of IL-22R−/− mice compare to WT mice. We conclude that IL-22R associated cytokines act in ACD mainly by inducing acanthosis, and indirectly by increasing skin neutrophilic infiltrate.

Temporary henna tattoo is unsafe in atopic children

Temporary henna tattoos have become increasingly popular as a safe alternative to permanent tattoos among American and European children and teenagers during the summer holidays. Currently, temporary henna tattoos contain not only henna, but also other additives such as para-phemylenediamine (PPD), which is considered to be the chemical agent that most frequently causes skin reactions associated with the use of commercial black henna. In this report, we describe an 11-year-old boy who applied a temporary black henna tattoo on his right arm during the summer holidays in Greece and developed a severe contact dermatitis at the tattoo site with residual hypopigmentation. He had no previous history of contact dermatitis, however he did suffer from seasonal allergic rhinitis and atopic dermatitis. Patch testing revealed a strong reaction to PPD, a substance commonly contained in temporary henna tattoo preparations. Henna tattoos are an increasing problem worldwide since they carry an increased risk of severe skin reactions; therefore we suggest that the use of temporary henna tattoos in children be discouraged.

Allergic Contact Dermatitis To Temporary Henna Tattoos

Introduction In the last years there have been increasing reports of adverse cutaneous reactions to temporary black henna tattoos. Black henna does not exist naturally, it is obtained from original henna after the addition of other compounds, among them paraphenylenediamine (PPD), that darken it and facilitate the process of tattooing. Paraphenylenediamine is an aromatic compound that presents cross-reactions with other components that have a benzene ring in their molecular structure. Many of these products may be present in the daily life of any person. Material and methods We reviewed patients that have shown erythema, inflammation and/or vesiculation in a previously tattooed area. The patients have undergone a temporary tattoo in street stalls during the summer period (2004-2005). A total of five patients were included, there were four men and one woman with a mean age of 13 years (3-34) and a mean latency period of 9.4 days (5-14). Black ink and plastic stencils were used to perform the tattoo. None of the patients has had previous contact with hair dyes or tattoos and none of them referred a personal history of atopic dermatitis. Patch testing was carried out using the standard set of the Spanish Group for Research in Contact Dermatitis [GEIDC] (TRUE TEST ®, Pharmacia, Hillerod, Denmark), with readings at 48 and 96 hours. Results Sensitization to PPD is confirmed in three patients, one of them was also sensitized to formaldehyde. Hypopigmented scars persist in three patients. Conclusions Black henna pseudotattoos are a source of sensitization to PPD with potential severe consequences in a medium to long term. Currently there is no specific legislation with respect to the practice of this type of tattoos in our country.

A temporary henna tattoo causing hair and clothing dye allergy

Contact dermatitis following the application of temporary paint-on henna tattoos indicates a potentially serious problem of active sensitization. We describe 2 cases involving sisters who travelled to Bali together and acquired a temporary black henna tattoo to the lower back region. Both sisters subsequently developed a contact dermatitis at the tattoo site, the dermatitis disseminating in one sister. There was persistent hyperpigmentation at the tattoo site in both sisters several months after the application. Patch testing revealed a positive reaction to para-phenylenediamine (PPD) in both sisters. One sister also showed reactions to other hair dyes and to multiple organic dyes. Allergic contact dermatitis to PPD contained in temporary henna tattoos is an increasing problem worldwide, with cross-reaction to related compounds and permanent skin changes, a frequent consequence of sensitization to this significant allergen.

A new approach to patch testing patients with para‐phenylenediamine allergy secondary to temporary black henna tattoos

A new approach to patch testing patients with para‐phenylenediamine allergy secondary to temporary black henna tattoos

Dermatitis associated with henna tattoo

A 32-year-old woman presented with a 5-day history of a severely pruritic, erythematous reaction in the distribution of a temporary black henna tattoo that had been applied 2 weeks earlier while she was vacationing on theboardwalk in New Jersey. She was not a cosmetologist and had no history of previous exposure to henna in hair dyes. In fact, the patient had no history of ever coloring her hair. She denied having a history of allergic contact dermatitis, atopy, and asthma. Physical examination revealed a geometric, erythematous, edematous, crusted lesion in the sun-shaped pattern of the patient's henna tattoo on the medial aspect of her right ankle (figure 1). A diagnosis of allergic contact dermatitis was made. She was treated with 60 mg of oral prednisone taken daily and tapered over 2 weeks. Topical triamcinolone acetonide cream was applied to the area twice daily and as needed for pruritus, and she was cautioned to avoid any exposure to henna in temporary tattoos and hair-dye products. Patch testing revealed a 2+ reaction to p-phenylenediamine (PPD). The remainder of the patch test was negative. The patient was then advised to avoid all permanent hair-dye products. She returned for follow-up about 1 month later. At that time, the dermatitis had resolved, leaving a faint hyperpigmented area in the design of the henna tattoo.

Dermatitis de contacto por pseudotatuaje de henna negra

Abstract—Henna is a natural dye extracted from the Lawsonia inermis shrub, whose use is on the rise, especially among children and young adults, due to the fashion trend of temporary tattoos. To make the tattoos last longer or intensify their color, different products are added to the henna, some of which are known sensitizing agents, such as paraphenylendiamine (PPD). We present the case of a 10-year-old boy who presented with an erythematous, pruritic plaque on the side of the right arm 2-3 weeks after getting a temporary black henna tattoo. The lesion disappeared after treatment with topical and systemic corticosteroids, leaving transient residual hypopigmentation, which cleared up spontaneously in 3 months. Skin testing showed contact sensitization to PPD, azo dyes and benzocaine, which were considered cross-reactions to the PPD, and to tetraethylthiuram.We would like to draw attention to the fact that this fashion of temporary black henna tattoos may cause sensitization with future repercussions.