Clinic and Polyclinic for Dermatology, Carl Gustav Carus University Hospital, Technical University Dresden, Fetscherstrasse 74, Dresden, Germany.
J Dtsch Dermatol Ges. 2012 Apr;10(4):258-64. doi: 10.1111/j.1610-0387.2011.07756.x. Epub 2011 Aug 3.
Semipermanent henna tattoos containing para-phenylenediamine (PPD) are a well-known cause of severe contact dermatitis, mainly in children. Another relevant exposure source to PPD are hair dyes, which are increasingly used by children and have also been reported to cause intense facial and scalp dermatitis. German patch test guidelines for children recommend that PPD should only be tested in patients who have had a henna tattoo, and then at a reduced concentration of PPD 0.5 % for 24 hours.
We report on patch test results in four patients, three children and one adolescent, with a history of contact dermatitis to henna tattoos or hair dye. We used the recommended or even lower patch test concentrations of PPD with 24-hours exposure in all patients.
All patients showed very strong patch test reactions to PPD and cross-reactions to related compounds even after dilution of PPD to as low as 0.05 %. Therefore, we suggest that in children with a history of allergic reactions to this compound, a titration test should be performed beginning at a concentration of maximal 0.05 %. This procedure has also been proposed previously based on a larger cases series in adults.
含有对苯二胺（PPD）的半永久指甲花纹身是严重接触性皮炎的已知原因，主要发生在儿童中。PPD 的另一个相关暴露源是染发剂，儿童越来越多地使用染发剂，也有报道称其会引起强烈的面部和头皮皮炎。德国儿童斑贴试验指南建议，只有在患者有指甲花纹身的情况下，才对 PPD 进行测试，然后以 PPD 0.5%的浓度进行 24 小时测试。
我们报告了 4 例有指甲花纹身或染发剂接触性皮炎病史的患者（3 例儿童和 1 例青少年）的斑贴试验结果。我们在所有患者中使用了推荐的甚至更低浓度的 PPD（24 小时）进行斑贴试验。
所有患者对 PPD 均表现出强烈的斑贴试验反应，即使在将 PPD 稀释至低至 0.05%时，仍对相关化合物表现出交叉反应。因此，我们建议在对该化合物有过敏反应史的儿童中，应从最大浓度 0.05%开始进行滴定试验。此前也根据更大的成人病例系列提出了这一程序。
