Paraphenylenediamine (Hair Dye) Poisoning: A Prospective Study on the Clinical Outcome and Side Effects Profile

Abstract

Background: Systemic poisoning with paraphenylenediamine (PPD) also known as Kalapathar, is an emerging suicidal trend in developing south Asian and African countries. The clinical distinction of hair dye toxicity comprises severe angioedema of the face and neck, tongue swelling resulting in upper airway obstruction, acute liver injury, myocarditis, and rhabdomyolysis complicating to acute kidney injury.Aim: To raise awareness, document the characteristic clinical spectra, and prevent and predict the outcome of poisoning (suicidal or accidental) with PPD (hair-dye) based on clinical complications, early baseline laboratory results and creatine phosphokinase (CPK) levels monitoring.

Kala Pathar (Paraphenylenediamine): the Frequent and fatal poisoning

“…If put PPD on eyes, it could irritate, cause hives, arthritis, asthma, lacrimation, or even blindness. Orally taking 7-10g of PPD, which is the lethal amount for our patients, causes sudden tongue swelling, trouble swallowing and speaking, stridor, and severe cervicofacial edema, which often needs an emergency tracheostomy to clear the airways 6,7 . People who take PPD are more likely to die.…”

Emerging Problem Evaluation of Hypocalcemia in Super Vasmol Hair Dye Poisoning Patients: Clinical Study in RIMS, Kadapa

“…4 Cervico-facial edema, angioedema, neck swelling, throat swelling, tongue swelling, dark urine, oliguria, stridor, hypotension, tachycardia, chest pain, dysphagia, dyspnea and burning sensation in the throat are all clinical manifestations of super vasmol poisoning. 5,6,7 There are a number of complications, including rhabdomyolysis, acute tubular necrosis, angioedema, hypocalcemia, myocarditis, metabolic acidosis, and arrhythmias. 8,9 The typical chocolate brown coloured urine could be confirmative proof for hair dye poisoning.…”