Clinical Profile and Outcomes of Hair Dye Poisoning in a Teaching Hospital in Nellore

Abstract

Demographic profiles, volume consumed, time to hospitalization, clinical presentation, laboratory findings, treatment details, and outcomes of patients with hair dye poisoning were analyzed to assess the effect of Super Vasmol 33. The efficacy of methylprednisolone as compared to hydrocortisone in patients was also investigated. Findings show that there are significant differences in the clinical profiles laboratory markers such as markers of leukocytosis, rhabdomyolysis, and hepatitis among patients who consumed fewer volumes than larger volumes. Toxicity is dose dependent with increased morbidity and mortality. Consumption of even lower volumes resulted in hepatitis. For an apparently similar clinical and laboratory profile of patients, treatment with hydrocortisone is as effective as methylprednisolone in the clinical outcomes. These findings suggest that Super Vasmol 33 is emerging as a major source of poisoning.

Toxicological studies on commercial hair dye brand commonly used in Saudi Arabia: histological study of the liver, kidney, heart, and testis

“…Toxic effects of these ingredients could have had additive effect in the patient (Chandran et al, 2012). The combined effect of the individual compounds may be responsible for its significant morbidity and mortality (Kondle et al, 2012).…”

“…The effects of PPD when ingested are serious and may cause cervicofacial edema, mucosal injury, respiratory distress, acute renal failure, rhabdomyolysis, and myocardial injury, cardiotoxicity and arrhythmias as well as atrophy of the optic nerve resulting in blindness in a patient who ingested an estimated amount of 7 g paraphenylenediamine and cause death (Bhargava & Matthew, 2007;Chandran et al, 2012;Kondle, Pathapati, Saginela, Malliboina, & Makineedi, 2012;Nohyneka, Fautzb, BenechKiefferc, & Toutaina, 2004;Sanchez, Handyal, Kannan, Siddalingeshwara, Alvarez-Uria, Gavalda, & Cobella, 2016;Senthilkumaran & Thirumalaikolundusubramania, 2015). It is reported that some commercial hair dyes contain a potent nephrotoxic cocktail containing PPD, propylene glycol, and resorcinol and histological changes of acute tubular necrosis have been described in PPD poisoning (Prabhakar & Kamalakar, 2012).…”

“…As there is no specific antidote, the management of poisoning includes gastric lavage, antihistamines, parenteral steroids, and alkalinization of the urine. Respiratory distress is the major early challenge, which may require ventilator support (Kondle et al, 2012). Renal support in the form of dialysis is required in acute renal failure (Kondle et al, 2012).…”

“…Renal support in the form of dialysis is required in acute renal failure (Kondle et al, 2012). Limited data were available on the head to head comparison of hydrocortisone and methyl prednisolone in hair dye poisoning (Kondle et al, 2012).…”

“…The concentration of PPD in hair dye formulation varies from 70 to 90% in stone hair dye and 2-10% in branded dyes (Kondle et al, 2012), which are used for giving black color to hair. Exact concentrations of PPD in different formulations are not known because most hair dye formulations are proprietary.…”