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A 17-year-old woman presented with firm, fiercely itching blisters on her fingers and the back of her hand. About 2 weeks beforehand, she had been tattooed with henna while on vacation. In contrast to conventional permanent tattoos, the skin is not penetrated; the henna dye is just painted on and fades in the course of time. Henna tattoos are popular as a vacation souvenir, particularly among the young. Allergic reactions to pure henna are rare; however, the strongly allergenic substance paraphenylenediamine (PPD) is often added to make the color more intense and to accelerate the drying process. Once someone has been sensitized, they may have severe allergic reactions to the slightest amount of PPD for the rest of their lives, making it essential to avoid contact. That is far from easy, as PPD may be a constituent of hair colorants, cosmetics, textiles, plastics, and many other products. In an epicutaneous test after 72 h, our patient showed a triple-positive reaction to PPD. The skin returned to normal after aspiration of the blisters and topical application of high-potency glucocorticoids.

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