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Acute eczema after application of hair dye. The areas affected include the upper eyelid, ear, and neck.
Source publication
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 diagno...
Context in source publication
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Background:
A previous analysis of undesirable events (UEvs), reported to four major companies following the use of hair-colouring products in Europe, showed that the reporting rates were stable for both oxidative and direct hair-colouring products over the period 2003-2006.
Objectives:
In order to verify the impact of risk management measures i...
Citations
... Allergic contact dermatitis is an inflammatory skin condition induced by an immune reaction after sensitization to an allergen, diagnosed through patch tests. 1 Henna, derived from the leaves of Lawsonia inermis, is commonly used as a dye for coloring hair, nails and creating temporary henna tattoos, which are increasingly popular worldwide. 2 Henna can be combined with PPD to create black henna, which accelerates the dyeing process and enhances pattern definition. ...
... 3 Additionally, post-inflammatory hyperpigmentation, a reported side effect, can persist over time, resulting in aesthetic repercussions. 1 Sensitizations to allergens other than PPD may be due to cross-reactivity, and could occur due to the metabolic conversion of textile dyes in the skin to PPD. 1,4 The subsequent reaction to a hair dye containing PPD highlights the importance of reinforcing avoidance measures. ...
... It is estimated that approximately 2.5% of black henna tattoos users can become sensitized to PPD, leading to ACD to other PPD-containing products such as hair dyes. 3 Additionally, post-inflammatory hyperpigmentation, a reported side effect, can persist over time, resulting in aesthetic repercussions. 1 Sensitizations to allergens other than PPD may be due to cross-reactivity, and could occur due to the metabolic conversion of textile dyes in the skin to PPD. 1,4 The subsequent reaction to a hair dye containing PPD highlights the importance of reinforcing avoidance measures. ...
... Within dyes, PPD stands out as the predominant allergen [15][16][17] . PPD, an oxidative dye found in numerous coloring products 18 , exhibits its highest concentration in dark shades, although it is also present in brighter colors. Notably, some manufacturers may omit to declare their presence on product labels. ...
Hair cosmetics are in fashion. Numerous products are commonly used in combination. Frequent allergens are present in hair cosmetics, which, added to almost daily use, increase the risk of sensitization. Familiarity with the clinical distribution of the eczematous rash is necessary to seriously consider patch testing. There are haptens on the market, although not all of them. It is necessary to know how to patch your own products. When avoidance of the allergen cannot be possible, new treatments are being evaluated to combat allergic contact dermatitis, mainly of the occupational type. In this manuscript, a complete and practical review of the main allergens and contact sources of hair cosmetic origin has been carried out.
... 3 They do not contain known contact allergens and can be easily washed out, but lack in quality of the coloring result and duration. Some PPD-free commercial products as proposed by Encabo Durán et al are presented in Table 4. 67 Semipermanent dyes often contain PPD, TDA, and their salts, though less frequently in selfusing products compared with professional. 51 ...
Widespread use of oxidative hair dyes during the past decades has raised questions on the potential allergy reactions and their management, as well as prevention measures for both professionals and consumers. Allergic contact dermatitis can be elicited by various hair dye-related allergens, though the main problem remains with p-phenylenediamine and related aromatic amines. If allergy is suspected, patch testing identifies the responsible hapten. Individuals sensitized to specific permanent hair dyes substances should avoid the exposure to these chemicals, but also be aware of possible cross-sensitization to other similar compounds. Cross-reactions detected in patch-tested populations indicate that one cannot safely use alternatives, although cross-reactivity is not always clinically relevant. An open application hair dye allergy self-test is recommended by manufacturers for early detection of allergy predisposition in consumers, although the lack of standardized conditions makes the efficacy of this process doubtful. Appropriate use of hand gloves, especially nitrile, is the most efficient prevention measure for professional hand eczema. In this systematic review, we focus on cross-reactions among hair dye-related allergens and make an attempt to answer some, frequently encountered by physicians, questions, while presenting the prevalence of the hair dye-related allergens.
... Paraphenylenediamine is added to hair dyes to intensify the color and increase dye durability, which ultimately explains its association with scalp lesions. 8 Sensitization to formaldehyde and its releasers, such as Quaternium 15, Bronopol, and Germall-115, occurs either alone or in combination. In the present study, four individuals allergic to formaldehyde also showed sensitization to at least one of its releasers. ...
... ACD at loose tissue sites, such as eyelids, lips, and genitals, can appear as diffuse swelling with unclear boundaries and loss of skin texture. For example, the clinical manifestation of ACD due to hair dye contact allergy is diffuse swelling of the eyelid and face, which closely resembles angioedema [12]. ...
Contact dermatitis (CD) is a common inflammatory skin disease caused by exposure to contact allergens and irritants. It is also the most common reason of occupational dermatitis and contributes greatly to hand dermatitis and facial dermatitis. Besides the two major forms of contact dermatitis: allergic contact dermatitis and irritant contact dermatitis, other subtypes of CD have been recognized including immediate skin reactions, photoinduced contact dermatitis, systemic contact dermatitis, and non-eczematous contact dermatitis. CD is a great imitator which can mimic many kinds of skin diseases, such as atopic dermatitis, lichen planus, and angioedema. For the diagnosis of CD, a complete medical history, including occupational history, is very important. It can give a clue of CD and provide a list of suspected substances. Besides the well-known diagnostic test, patch testing, there are many other diagnostic tests can be used to help diagnosis of CD and identify the causative allergens, including photopatch test, skin tests for detecting of immediate contact reactions, serum allergen-specific IgE test, and qualitative and quantitative testing of allergen in the suspected materials patients exposed to and challenge test. Before the treatment, the suspected irritants or allergens should be avoided completely. This includes both the removal of the patient from the environment that contains those substances and the promotion of the metabolism and expulsion of the allergens that have been absorbed by the body. In addition, it is also important to restore the skin barrier and reduce skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines, as well as systemic corticosteroids and immunosuppressants. Early and appropriate treatments are important to prevent further deterioration and persistence of the skin condition.
... 55 Consequently, the sensitising behaviour of p-phenylenediamines, especially PPD, has been the subject of many investigations. [101][102][103][104] Research continues into the biochemical impact of topical application of actives like PPD to acquire an exact understanding of the mechanism of sensitisation and reason(s) for the difference in tolerance within the population. 105 Even if a consumer avoids using products containing a substance to which that individual is sensitised, cross-elicitation may occur, that is, ACD is provoked in PPD-sensitive individuals by other actives (eg, TDS and PAP). ...
This paper reviews developments in industrial colorants as active ingredients of commercial products that rely on oxidative chemistry for the coloration of human hair. After outlining the regulatory challenges faced by the industry, which are shaping the landscape of colorant usage, the most commercially important actives utilised in oxidative hair colorant formulations are surveyed from the perspective of their chemistry and economics. Some developments in the form of recently introduced actives are also described.
... Conversely, in the process of PPD oxidation Bandrowski's base (BB) well known as mutagenic compounds inducing allergic reaction, also could be formed by autooxidation in the presence of air, or by promoting the oxidation reaction with oxidants including hydrogen peroxide [7,8]. Although, skin functions as the first line of defense system against toxic chemicals and foreign substances, PPD exposed through skin epidermal layer can be absorbed by percutaneous absorption during hair dyeing or a tattooing process, resulting in allergic contact dermatitis [9][10][11][12]. Additionally, many previous studies reported that PPD possessed mutagenic, cytotoxic and carcinogenic effects on human organs including liver, kidney and bladder [13][14][15][16][17][18]. ...
para-Phenylediamine (PPD), a major component of hair dyeing ingredients, can induce allergenic sensitization and exert mutagenic, tumorigenic and cytotoxic effect. In this study, we determined the cytotoxic effect of PPD on human keratinocytes and evaluated the protective effect of Rhus semialata M. extracts (RSE) on PPD induced cytotoxicity for the first time. We observed that RSE is a strong inhibitory agent against PPD-induced toxicity in human keratinocytes. The results indicated that RSE pretreatment significantly could suppress PPD induced cytotoxic effects, including decrease of cell viability, accumulation in subG1 phase of cells, and relocation of phosphatidylserine on keratinocytes. Also, we found that PPD caused cytotoxicity was associated with mitochondrial membrane potential loss and subsequent activation of caspase and PARP degradation. However, pretreatment of RSE showed preventive activities against PPD induced mitochondrial membrane potential loss and ROS production in keratinocytes. In conclusion, the results of present study suggest that RSE was able to protect the skin from several cytotoxic effects of PPD and could be a meaningful material in many industries using PPD.
... One study investigated 159 hair dye kits purchased at major United States supermarket chains and found 21% contained PPD. 4 Common potential dye crossreactors include 2,5-toluenediamine sulfate, p-aminophenol, and m-aminophenol. 5 In summary, common sites of consumer PPD hair dye allergy include face, neck, trunk, and scatteredgeneralized. In contrast, PPD allergy from hair dye in patients with occupationally related skin disease occurred more frequently in men and on hands/ arms. ...
... [8][9][10][11][12][13][14][15] Experience with the lymphocyte transformation test has been predominantly with metals, and in particular nickel, although somewhat variable results have also been reported with certain organic contact allergens, including: 2,4-dinitrochlorobenzene, 9 methylisothiazolinone (MI), 7 and p-phenylenediamine (PPD). 11,12 In the present investigations, the lymphocyte transformation test was used to explore further the characteristics of T lymphocyte responses to nickel (as nickel sulfate), and to PPD, which is a proven contact allergen in hair dyes and henna tattoos 1,16 (delivered in culture as a hapten-protein conjugate). Furthermore, the relative frequencies of discrete subpopulations of T lymphocytes were measured in subjects sensitized to PPD or nickel. ...
Background
There is considerable interest in understanding the immunological variables that have the greatest influence on the effectiveness of sensitization by contact allergens, particularly in the context of developing new paradigms for risk assessment of novel compounds
Objectives
To examine the relationship between patch test score for 3 different contact allergens and the characteristics of T‐cell responses.
Patients/Materials/Methods
A total of 192 patients with confirmed nickel, p‐phenylenediamine (PPD) or methylisothiazolinone allergy were recruited from the Contact Dermatitis Investigation Unit at Salford Royal Hospital. Severity of allergy was scored by patch testing and peripheral blood lymphocytes characterized for T cell phenotype by flow cytometry and proliferative activity by radiolabelled thymidine incorporation. Comparisons were drawn with buffy coat samples from healthy volunteers.
Results
Patch test positivity to nickel, PPD and MI was associated with changes in the phenotype of peripheral blood T‐cells: increases in naïve cells, decreases in Treg cell frequency and the CD4⁺:CD8hi ratio and increased expression of the skin homing marker CLA, particularly for those patients with a +++ patch test score.
Conclusions
This increased understanding of the characteristics of the T cell responses to contact allergens may provide parameters to better measure health risks associated with skin sensitization.
This article is protected by copyright. All rights reserved.
Background
There is still limited clinical‐practice data on specific clinical and patch test features, as well as on allergen clusters in polysensitization (PS).
Objectives
To determine the frequency, relevance, symptoms duration and risk factors in polysensitized patients and to assess possible allergen aggregation.
Methods
Prospective multicentric study (January 2019–December 2022) conducted in setting of the Spanish Contact Dermatitis Register (REIDAC). Clinical and patch test data of polysensitized and oligosensitized patients were compared, and risk factors of PS were investigated with logistic multivariate regression. Unsupervised hierarchical clustering and network analysis were used to study allergen aggregation in PS.
Results
A total of 10,176 patients were analysed. PS was found in 844 (8.3%). Current relevance was significantly higher in polysensitized patients ( p < 0.01). Risk factors for PS were atopic dermatitis (OR: 1.58, 95% CI: 1.24–2.02), age (≥60 years vs. ≤24 years, OR: 1.75, 95% CI: 1.25–2.44) and some special locations (legs vs. face OR: 1.54, 95% CI: 1.05–2.25, hands vs. face OR: 1.46, 95% CI:1.15–1.85, arms vs. face OR: 1.49, 95% CI:1.01–2.20, trunk vs. face OR: 1.40, 95% CI:1.06–1.85). Cluster and network analyses revealed specific‐allergen clusters and significant associations, including allergens belonging to metals group, fragrances and botanicals group, topical drugs group, rubber allergens and biocides.
Conclusions
This study confirms that PS is structured by discernible patterns of specific‐allergen clusters and reinforces significant allergen associations in PS. Cross‐reactivity and/or concomitant sensitization could explain the formation of allergen clusters in PS.
