Neutrophilic and Eosinophilic Dermatitis Caused by Contact Allergic Reaction to Paraphenylenediamine in Hair Dye

Abstract

Background: Paraphenylenediamine (PPD) in hair dyes can cause systemic as well as cutaneous allergic reactions such as neutrophilic and eosinophilic dermatitis. The symptoms are often severe. The acute lesion is normally histologically indistinguishable from any eczematous reaction with marked spongiosis. Observations: We report a case of allergic contact dermatitis caused by the use of hair dye containing PPD that developed in a patient who had been using the same hair dye for many years. Her symptoms included scalp dermatitis and widespread skin lesions as well as lymphadenopathy and quite possibly dyspnea resembling asthma. What is most remarkable about this case is the histopathologic finding of neutrophilic cellulitis and a marked neutrophilic infiltrate with variable spongiosis. This unique finding was confirmed by histologic analysis of a patch test lesion specimen. Conclusion: It is always important to consider contact allergic dermatitis as a cause of dermatitis because of the variable presentation of the disease, including unique histologic findings that do not fit the conventional picture, as in the present case.

Discoid lupus triggered by allergic contact dermatitis caused by a hair dye

“…In our case, the triggering allergen was found to be PPD, a potent contact sensitizer, for which other atypical clinical presentations have been reported, such as Sweet‐syndrome‐like dermatosis , erythema multiforme , angioedema , and leukoderma . However, to our knowledge, this is the first case of an exacerbation of DCLE following the application of a PPD‐containing hair dye in a sensitized individual.…”

Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism?

“…Sometimes, the localized eruption may become generalized and associated to systemic symptoms as fever and malaise [50, 51]. Exceptionally, a Sweet syndrome [52], Wells syndrome [53, 54], prurigo nodularis [55] and connubial contact dermatitis [56, 57] have been also described.…”

Ultrasound assessment of reactive lymphadenopathies due to extreme reactions from patch tests

“…On the other hand, reactive lymphadenopathies may follow severe ACD from potent sensitizers such as p ‐phenylenediamine 4 or propolis 5 . In addition, cervical lymphadenopathy is a well‐known side effect of topical immunotherapy with diphenylcyclopropenone (involving 17.6% of alopecia areata patients thus treated) 6 or squaric acid dibutylester 7 .…”