Black henna tattoo: Risk of developing allergic contact eczema

Abstract

Henna is used for coloring hair, but also to draw labile skin tattoo. Henna is often mixed with paraphenylenediamine (PPD). We report the case of a female patient presenting with contact eczema due to labile tattoo containing PPD. The study involved a 23-year old young woman with an aesthetic Black Henna tattoo on the back of the hand and on the forearm. This labile tattoo contained PPD. Two days later, the patient developed intensely pruritic, burning erythematovesiculosus and edematous lesions. The lesions involved the tattooed area, corresponding with the original drawing. The lesions were improved using Class 1 of topical corticosteroids (Clobetasol propionate). The patient refused allergy patch testing, so no allergy test was performed. Now, henna is very popular in the western countries. PPD is added to reduce the fixing time or to obtain a darker coloration. It can result in severe systemic reactions. The most frequent allergic reaction is contact dermatitis. Treatment is based on local corticosteroid therapy. A better regulation on labile tattoo, the control of preparations as well as a regular annual information for the general public are essential. The interest of our study lies in highlighting the importance of informing, especially young people, on the risks of labile tattoo.