[Para-phenylenediamine allergic contact dermatitis due to henna tattoos in a child and adolescent population]

Early presentation of allergic contact dermatitis due to paraphenylenediamine

Allergic contact dermatitis (ACD) is a more frequent pathology in adults than in children, because, in most cases, allergic sensitization requires a prolonged exposure time to the allergen, mostly months or years. In fact, the actual incidence and prevalence of ACD in children and adolescents is unknown. However, there is a hypothesis that ACD is increasing in the pediatric population. Among the allergens involved in ACD, the frequency of paraphenylenediamine (PPDA) is increasing. PPDA is one of the five most common contact allergens in the general population and one of the 10 most common contact allergens in children. The most relevant sources today are henna tattoos and hair dyes. Currently, European Union legislation limits the use of PPDA in hair dyes and prohibits its use in henna tattoos. Despite this legislation, the use of henna tattoos with PPDA is becoming more frequent in younger ages. We report an early presentation of ACD by PPDA, with a permanent hypopigmented skin area as an aftermath, in a 7-year-old male child. We believe that health authorities should advise against making these tattoos in children.

p-Phenylenediamine induces epithelial-mesenchymal transition in SV-40 immortalized human urothelial cells via the ERK5/AP-1 signaling

PURPOSE

To investigate whether p-Phenylenediamine (PPD) could triggered EMT inSV-40 immortalized human urothelial cells (SV-HUC-1), and the regulation role of ERK5/AP-1 during this process.

MATERIALS AND METHODS

SV-HUC-1 cells were treated with different concentrations of PPD. MTT assay was employed to detect cell viability. Wound healing and transwell assay were performed to detect migrative and invasive capacity. Western blot and qRT-PCR were utilized for detecting molecular changes. ERK5 specific inhibitor was used to suppress ERK5 signaling.

RESULTS

Migration and invasion capacity of SV-HUC-1cells were enhanced after PPD exposure. Expression of epithelial markers E-cadherin and ZO-1 was decreased and expression of mesenchymal markers N-cadherin and vimentin was increased after being cultured with low concentrations of PPD, indicating that PPD induced EMT in PPD-cultured SV-HUC-1 cells. Meanwhile, PPD triggered activation of ERK5signaling and downstream AP-1 was activated, but no obvious influence of PPD on other sub-families of MAPK was detected. After inhibition of ERK5/AP-1, PPD-induced enhancement of migrative and invasive abilities were attenuated and expression of EMT markers was also reversed.

CONCLUSION

PPD may be a carcinogen, which could induce EMT in SV-40 immortalized human urothelial cells (SV-HUC-1) via activating ERK5/AP-1 signaling.

Para-phenylenediamine deteriorates oocyte quality by impairing mitochondrial function

Several studies demonstrate that para-phenylenediamine (PPD) is often added to permanent oxidative hair dyes. Sub-chronic topical exposure to PPD in male rats damages their testicular function; however, little is known about the effects of PPD exposure on the female reproductive system, especially on oocyte quality. In this study, we found that PPD can affect the meiotic capacity of oocytes and their fertilization potential. In particular, PPD can damage the spindle/chromosome structure and prevent oocytes from developing and maturing normally. Furthermore, PPD exposure compromised the dynamics of cortical granules and their component, ovastacin. In addition to the protein level of Juno, the sperm receptors on the egg membrane, were substantially impaired in PPD-administered oocytes, thus leading to fertilization failure. Finally, we found that PPD exposure resulted in abnormal mitochondrial function, which led to oocyte degeneration, apoptosis, and increased ROS levels. Altogether, our study illustrates that mitochondrial dysfunction and redox perturbation are the major causes of the poor quality of oocytes exposed to PPD.

Alergia por henna: tatuajes que dejan huella

La mezcla de la henna natural con parafenilendiamina (PPD), un colorante sintético potenciador del color y la duración de los tatuajes, puede producir una reacción infrecuente de hipersensibilidad tipo IV. Presentamos el caso clínico de una mujer que presentó una reacción cutánea intensa un mes después de hacerse un tatuaje con henna negra. Dicha reacción se manifestó con maculopápulas sobreelevadas que reproducen el dibujo del tatuaje. Palabras claves: piel, alergia, hipersensibilidad.

Hair dye and risk of skin sensitization induction: a product survey and quantitative risk assessment for para-phenylenediamine (PPD)

BACKGROUND

Para-Phenylenediamine (PPD) is a commonly used dye intermediate in permanent hair dye formulations, and exposure to PPD has been associated with allergic contact dermatitis at certain doses.

PURPOSE

Determine the concentration of PPD in a survey of self-application permanent hair dye products, and perform a quantitative risk assessment to determine the risk of skin sensitization induction following application of these products.

METHODS

Consumer exposure levels (CELs) to PPD following application of hair dye products were estimated using the maximum amount of hair dye that can adhere to the surface area of the scalp, the measured concentration of PPD in the hair dye product, a retention factor, the dermal absorption of PPD, and the surface area of the scalp. CELs were calculated for various exposure scenarios, and were stratified by hair dye shade.

RESULTS

All estimated CELs did not exceed the acceptable exposure level. Specifically, margins of safety ranged from 2.3 to 1534 for black dyes, 2.9 to 5031 for brown dyes, and 26 to 5031 for blonde dyes.

CONCLUSIONS

Findings suggest that use of the evaluated permanent hair dyes, under the evaluated exposure scenarios, would not be expected to induce skin sensitization due to PPD exposure at concentrations ≤0.67%.

Allergic Contact Dermatitis Due to Paraphenylenediamine: An Update

Paraphenylenediamine (PPD) is an amine that is mainly used as an ingredient in hair dyes and henna tattoos. The incidence of allergic contact dermatitis to PPD is increasing, particularly in younger patients. In this article, we review the main sources of PPD and the substances with which it can interact and present a practical algorithm for diagnosing and treating suspected cases of PPD allergy.

Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature

Background: The use of temporary henna tattoos has increased dramatically in recent years, especially in children and adolescents. To obtain a darker colour and prolong the life of the tattoo, red henna, a plant-derived substance, is typically added to para-phenylenediamine (PPD). The mixture is called temporary black henna tattoo (TBHT). Because of its molecular characteristics, PPD can induce skin sensitization that may cause various clinical manifestations with successive exposures, among which the most common is allergic contact dermatitis (ACD). This report describes two paediatric cases of PPD sensitization and ACD after the exposure to TBHT and summarizes the literature on this emerging clinical problem. Case Presentation: We describe two cases of childhood-onset ACD that occurred 2 and 10 days, respectively, after the application of a TBHT during the summer holidays. Patch tests showed an evident positive response to 1% PPD in both cases. Sensitization to PPD occurred in the first case because a previous henna tattoo did not result in overt symptoms; in the second case, the reaction occurred after the same tattoo was retouched. In both cases, hypopigmentation persisted and both the patients and their families were advised to avoid further contact with PPD-containing materials and substances that could lead to cross-reactions. Conclusions: Sensitization to PPD is a growing phenomenon in children. The most common cause appears to be exposure to TBHT in which PPD might be present at unknown or high concentrations. Once sensitization occurs, patients may experience severe clinical symptoms which can present with a persistent hypopigmentation when they are re-exposed to substances that contain or cross-react with PPD. Given the widespread use of PPD, TBHT could adversely affect the daily life of paediatric patients; thus, for this reason, this practice as a fashion accessory must be discouraged. In addition, it is extremely important to provide scientific information on the risks of TBHT to consumers, especially to adolescents and to the parents of younger children to prevent PPD sensitization.