Temporary henna tattoo reactions in children

Abstract

Case 1 A 9‐year‐old girl applied a temporary henna tattoo to her right arm and 1 week later repeated the same process. In the following 2 days, erythema and papulovesicular eruptions developed at the application site (Fig. 1). Patch tests were performed with the European Standard Series, specific hairdressing agents, and commercial and natural henna. The patient showed a 3+ reaction to both natural henna and ‘‘para‐phenylenediamine (PPD)’' 1% and a 3+ reaction to nickel sulfate 5% at 48, 72, and 96 h (Fig. 2). She was treated with topical steroid cream (beclomethasone dipropionate), applied twice daily. A slight postinflammatory hypopigmentation was observed at the time of the patch test. The hypopigmentation has gradually decreased in severity over time (Fig. 3). 1 Case 1: temporary henna tattoo reaction with papulovesicular eruptions 2 Case 1: patch test results. (A) 3+ reaction to nickel sulfate 5%; (B) 3+ reaction to para‐phenylenediamine (PPD) 1%; (C) 3+ reaction to natural henna 3 Case 1: postinflammatory hypopigmentation Case 2 An 11‐year‐old boy was admitted to our outpatient clinic with itchy, erythematous, papulovesicular eruptions on the left arm. These lesions appeared after application of a temporary henna tattoo with a ‘‘do‐it‐yourself’' kit to the left arm. Patch tests were performed with the European Standard Series and commercial tattoo products. The patient showed only a 1+ reaction to commercial henna. He was treated with topical steroid cream (beclomethasone dipropionate), and 2 weeks later his lesions had totally disappeared. Case 3 A 12‐year‐old girl applied a temporary henna tattoo to her left arm. Several hours later, erythema, edema, and itching developed. Patch tests were performed as for Case 2. The patient showed a 2+ reaction to commercial henna. Topical steroid cream (beclomethasone dipropionate) was effective, and 3 weeks later the lesions had healed with slight hypopigmentation. The postinflammatory hypopigmentation traced the tattoo design exactly, which was in the form of a fish (Fig. 4). On follow‐up, the hypopigmentation was not permanent. 4 Case 3: fish‐shaped postinflammatory hypopigmentation

Temporary holiday “tattoos” may cause lifelong allergic contact dermatitis when henna is mixed with PPD

“…It is added to henna to speed up dyeing and to improve pattern definition. It has been known as a strong, delayed type skin sensitiser 4–7 …”

Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature

“…Compared to a permanent tattoo, TBHT is commonly considered to be more advantageous because there is no associated pain or risk of infection, and although it leaves a mark, it disappears after a few weeks and can be reapplied if desired [13,14,15]. For all these reasons, parents who authorize their children to receive the tattoos consider it a natural practice.…”

“…In the United States, the Food and Drug Administration has found PPD concentrations in henna ranging from 4.9% to 27.2% [19]. In addition to the high and, in some cases, unknown concentrations of PPD in henna tattoos, there are other elements that can promote sensitization: prolonged contact with the skin and the lack of an oxidizing substance that neutralizes the effect; the use of oils or solvents; a hot environment that increases the local temperature of the skin facilitating the percutaneous penetration; the use of syringes to apply the dye; the use of occlusive dressings to keep the henna attached to the skin; and the retouching of tattoos [15,20]. Some of these factors could have played a role in both of our cases.…”

Nail-Splinting Technique for Injured Nails: A Simple Device Made of a Surgical Glove

“…A review of the literature on these reactions revealed a few reported cases in dermatology, allergy, and pediatrics' journals [1][2][3][4][5][6][7][8][9] and none in the hand or plastic surgery literature. The aim of this communication is to increase the awareness of plastic surgeons to these skin reactions and their management.…”