Søsted H, Agner T, Andersen K E, Menné T
The National Allergy Research Centre for Consumer Products, Department of Dermatology, University of Copenhagen, Gentofte Hospital, Denmark.
Contact Dermatitis. 2002 Nov;47(5):299-303. doi: 10.1034/j.1600-0536.2002.470508.x.
Severe facial and scalp dermatitis following the use of permanent hair dyes has been reported in several cases. Para-phenylenediamine (PPD) is known as a potent contact allergen, and PPD is allowed in hair dye at a concentration of 6%. Hair dye reactions are usually diagnosed by the patients themselves, and adverse reactions to hair dye may not necessarily be recorded by the health care system, unless the reactions are especially severe. Based on this assumption, we suspected that hair dye dermatitis was occurring more frequently than reported in the literature. Consumer complaint-based data were obtained by advertising for persons with adverse reactions to hair dye. Among those responding to the advertisement, 55 cases of severe, acute allergic contact dermatitis were identified. The main symptoms were severe oedema of the face, scalp and ears, and clinically this was often mistaken for angio-oedema. The 55 cases comprised a total of 75 visits to the health service and 5 admissions to hospital. 18 persons had sick leave, which supports the impression of very severe dermatitis reactions. 60% were treated with antihistamine, while 52% were treated with corticosteroids. 29% of the cases were patch tested and all were found positive to PPD. Our data presented here clearly show that PPD and its derivatives in hair dye at the present concentrations presents a significant health risk for the population. Furthermore, the severe acute allergic skin reactions are often misdiagnosed in the health care system. The frequency of allergic contact dermatitis resulting from hair dye is likely to be underestimated. New methods to survey the frequency of adverse reactions should be considered.
已有多例使用永久性染发剂后出现严重面部和头皮皮炎的报道。对苯二胺（PPD）是一种强效接触性过敏原，染发剂中允许使用浓度为6%的PPD。染发剂反应通常由患者自行诊断，除非反应特别严重，否则医疗保健系统不一定会记录染发剂的不良反应。基于这一假设，我们怀疑染发剂皮炎的发生频率高于文献报道。通过招募对染发剂有不良反应的人，获取基于消费者投诉的数据。在回应广告的人群中，确诊了55例严重急性过敏性接触性皮炎病例。主要症状为面部、头皮和耳部严重水肿，临床上常被误诊为血管性水肿。这55例患者共就诊75次，住院5次。18人休了病假，这证实了皮炎反应非常严重的印象。60%的患者接受了抗组胺治疗，52%的患者接受了皮质类固醇治疗。29%的病例进行了斑贴试验，结果均显示对PPD呈阳性。我们在此呈现的数据清楚地表明，染发剂中目前浓度的PPD及其衍生物对人群构成了重大健康风险。此外，严重急性过敏性皮肤反应在医疗保健系统中常被误诊。染发剂引起的过敏性接触性皮炎的发生率可能被低估。应考虑采用新的方法来调查不良反应的发生率。
