Abstract:Body art and tattoos have become a ubiquitous part of modern culture and the popularity and availability of unregulated temporary henna-based tattoos has increased. The addition of para-phenylenediamine to natural henna makes the tattoo set quicker and gives a darker coloration; however, it is a potent allergen. We describe the case of an 11 year old girl who developed a Type IV delayed-type hypersensitivity reaction to a black henna tattoo. This case highlights the importance of public education about potent allergens that may be encountered in products such as henna tattoos.