p‐Phenylenediamine sensitization is more prevalent in central and southern European patch test centres than in Scandinavian: results from a multicentre study

Abstract

Background: Positive patch test reactions to p-phenylenediamine (PPD) are common. PPD is used in oxidative hair dyes and is also present in dark henna temporary 'tattoos'. Cross-sensitization to other contact allergens may occur. Because subjects sensitized to PPD are at risk of clinically severe reactions upon hair dyeing, there is a need for 'current' prevalence data on PPD sensitization. Materials: Patch testing was performed using PPD (1% free base in petrolatum from Trolab (Almirall Hermal GmbH, Reinbeck, Germany) or Chemotechnique (Malmo¨, Sweden), equivalent to 0.090 mg/cm 2 in the TRUE 1 test from MEKOS Laboratories AS). Statistical analysis was performed using the chi-squared test.Results: The weighted average prevalence was 4.6% among 21 515 patients. PPD sensitization occurred more often in centres located in Central and Southern Europe than in Scandinavian centres (odds ratio ¼ 2.40; 95% confidence interval ¼ 2.07-2.78). The overall proportion of positive patch test reactions to PPD that were registered as being of either current or 'past' relevance was high (weighted average 53.6% and 20.3%, respectively). Consumer hair dyeing was the most prominent cause of PPD sensitization (weighted average 41.8%). Furthermore, occupational hair dye exposure (10.6%) and cross-sensitization to textile dyes (12.6%) were frequently reported.Conclusions: PPD sensitization caused by exposure to hair dyes is frequent and remains a present problem for patients visiting contact dermatitis clinics, especially in patch test centres located in Central and Southern Europe.

Paraphenylene diamine exacerbates platelet aggregation and thrombus formation in response to a low dose of collagen

“…Moreover, data from Scandinavian, central and southern European patch test centers between 2003 and 2007 revealed among 21,515 patients a weighted average prevalence for PPD sensitization of 4.6% with PPD sensitization being more frequent in southern Europe (Thyssen et al, 2009).…”

The hair dyes PPD and PTD fail to induce a TH2 immune response following repeated topical application in BALB/c mice

“…In contrast, the immune response to TDI was clearly T H 2 dominant, demonstrating that these experimental conditions were sufficient to detect such a response to a well-known allergen. It is recognized that some of the chemicals in hair dyes can cause allergy in man, and although the extent to which this occurs has been the subject of some debate, it is evident that, overwhelmingly, such adverse reactions are a manifestation of cell-mediated (T H 1) delayed-type hypersensitivity (Thyssen et al, 2009;Krasteva et al, 2009Krasteva et al, , 2010Basketter et al, 2010). Only rare cases of Type 1 allergy responses following hair dye exposure were reported over a period of more than 20+ years (Table 1).…”

p-Phenylenediamine and Risk of Sensitization in Children

“…Data on adults from a multicenter study indicate that Middle and Southern European countries have a higher prevalence of contact allergy to PPD than Scandinavia [38]. This could indicate that geographical places with a population with darker skin color and hair, e.g., Southern Europe, could be dyeing their hair more often than, for example, Scandinavians with a higher prevalence of blond hair and different behavior intended to maintain a blonder look [38].…”

“…This could indicate that geographical places with a population with darker skin color and hair, e.g., Southern Europe, could be dyeing their hair more often than, for example, Scandinavians with a higher prevalence of blond hair and different behavior intended to maintain a blonder look [38]. Whether this could be applied to the population of children has not yet been proven.…”