Attempted suicide by ingestion of hair dye containing p-phenylenediamine: a case report

Abstract

Para-phenylenediamine is widely used as a chemical in hair dyes and in combination with henna. This dye is used to paint the body for decorative reasons, to speed the processing time of henna and to intensify the results. Para-phenylenediamine is widely used in the Middle East, North Africa and India. Several reports have been published of the fatal ingestion of hair dye containing para-phenylenediamine. Here, we describe the case of a 14-year-old girl who ingested the compound but whose prompt treatment prevented her death. Ingestion of para-phenylenediamine produces a typical triad of angioneurotic oedema, rhabdomyolysis and acute tubular necrosis. Awareness of signs of these associated conditions in our patient, together with a comprehensive history, facilitated appropriate treatment to be instituted. We document the steps we took to enable her complete physical recovery.

Clinical Presentation, Complication and Outcome of Black Stone (Paraphenylene Diamine) Poisoning

“…Khaskheli MS et al reported that the intent of poisoning was suicidal in 98.94% of his cases; however psychological evaluation was found to be normal in all these patients [23]. This indicated that most of suicidal attempts were impulsive precipitated by either scolding from parents, family quarrels or socioeconomic reasons [24]. In our study, all patients were exposed to hair dye (black stone) through oral route probably due to ease of administration.…”

Importance des réseaux sociaux dans l’origine des intoxications : à propos d’un cas d’empoisonnement par la paraphénylènediamine

“…En France, les enfants sont les principales victimes des intoxications par la PPD suite à l'ingestion de produits de teinture. Les intoxications chez l'adulte sont rares en France et en Europe, contrairement à l'Afrique du Nord où la PPD est responsable d'intoxications graves souvent mortelles, constituant une des premières causes de suicide en particulier chez les femmes jeunes [5][6][7].…”

Poisoning of paraphenylene diamine hair dye: review article

“…12 There are a wide varieties in clinical presentation, regarding gender , PPD was found prevalent more in female than males, this was reported by Mohamed et al in a retrospective study for ten years at Sudan. 13 Psychologic approach is curial since poisoning with PPD for suicide noticed to be among middle age population, this was observed in a case report study in Sudan by Lamis et al and in India by Verma et al 3,14 Again a cinema actor reported to had some quarrel with his parents about his marriage ingested PPD. 15 Hair dresser with regular exposure to PPD observed with high prevalence of renal impairment.…”

“…2 Nowadays, thousand of consumers use hair dyes, in the developing countries particularly North, East Africa particularly in Sudan, Morocco and Indian sub-continent due to easy availability and affordability, where it considered to be an emerging etiological factor for suicides through ingestion, since PPD is rapidly absorbed into the blood through mucous membranes of the digestive tract after its oral intake. [2][3][4][5] Majority of hair dye poisoning are suicidal in nature Moreover PPD may ingested accidently leading to high morbidity and mortality rate. PPD when applied to skin observed to cause contact dermatitis, erythematous urticarial papules, eczema as well as systemic effect.…”