[Hemolytic anemia after voluntary ingestion of henna (Lawsonia inermis) decoction by a young girl with G6PD deficiency]. / Ingestion volontaire de decoction de henné (Lawsonia inermis) d'un déficit en G6PD.

Henna (Lawsonia inermis) is a shrub bearing leaves that are crushed and used for cosmetic purposes in Asia and Africa. In several countries, henna decoction is ingested as a traditional drug to induce abortion. One component of Henna, known as Lawsone, can induce hemolysis in G6PD-deficient patients after cutaneous exposure or ingestion. The purpose of this report is to describe a case of severe hemolytic anemia after voluntary ingestion of Henna decoction to induce abortion. This complication led to diagnosis of partial moderate G6PD-deficiency in the 17-year-old patient living in Mayotte in the Indian Ocean. This report emphasizes the life-threatening hazards associated with some plant extracts used as traditional medicines.

Contact dermatitis with henna tattoo.

Allergic and irritant reactions to henna are rare. Para-phenylenediamine, which is sometimes added to obtain a dark, blackish henna, causes the majority of contact dermatitis reported related with tattoos. Allergic contact dermatitis due to temporary paint-on tattoo with black henna is described in two adolescents.

Allergic contact dermatitis to pure henna.

Henna is a naturally occurring brown dye made from the leaves of the tree Lawsonia inermis. The active ingredient of henna is lawsone (2-hydroxy-1, 4-naphthoquinone). It is traditionally used in Islamic and Hindu cultures as a hair coloring and as a dye for decorating the nails or making temporary skin tattoos. Actually, henna has a very low allergic potential. In most cases, allergic reactions not caused by henna, but by the chemical coloring additives that are added to henna mixtures. These additives include agents such as daiminotoluenes and diaminobenzenes. In this article, we report a case of allergic contact dermatitis from pure henna that is also used for the relief of rheumatic pain.

[Henna tattooing in children: natural or temporary?]. / Tatuaje de henna en niños: ¿natural y temporal?

BACKGROUND: Tattoos of natural red/brown henna obtained from the indigenous tree Lawsonnia have been traditionally performed with a few side-effects. Nowadays black henna tattoos are usually performed even in children. The addition of several chemical agents to improve its cosmetic properties has increased the risk of developing contact dermatitis after exposure. Our aim is to determine the causative agents of contact dermatitis in two children wearing henna tattoos. MATERIAL AND METHODS: Case 1: A 12-year-old girl with no atopy presented local vesicles 10 hours after a black henna tattoo was applied. She had presented similar symptoms with a previous tattoo. Case 2: A 7-year-old atopic boy presented vesicles 2 weeks after a black henna tattoo was applied. He had dyed his hair previously without side effects. Both patients cured, after 3-4 weeks of treatment with topic corticosteroids, with residual hypo-pigmentation. Skin prick test with natural and commercial henna and epicutaneous test with TRUE-TEST, PABA derivatives compounds tests, textile dyes and natural and commercial henna were performed. RESULTS: The epicutaneous tests were positive for p-Metilaminophenol, p-Aminobencene, p-Phenilendiamine and p-Toluenodiamine in both patients. The first patient had also positive tests for Benzocaine, Hydroquinone, Isobutyl p-aminobenzoate, Yellow 1 and Orange 1 disperse; the second one for Red 1 and Orange 1 disperse. In both cases the prick and epicutaneous tests for henna were negative. CONCLUSIONS: Two children presented contact dermatitis after black henna tattoo due to added additives such as paraphenilendiamine.

[Risks of black henna tattoos]. / Riesgos de los tatuajes de henna negra.

Temporary henna tattoos have become increasingly popular in the last few years, because of their apparent harmlessness and disappearance in few weeks. Black henna contains paraphenylenediamine (PPD), a synthetic colorant which is used in hair dyes and can cause sensitization. Many cases of allergic contact dermatitis occurring after tattooing have been reported, especially in children and teenagers during the summer time, since there are many tattoo-painters at holiday places and the parents are unaware of the risks of these tattoos. Clinicians, particularly pediatricians, primary care physicians and dermatologists should seek to remedy this misinformation. We can be the first person to be consulted before the tattoo painting and we will treat patients with lesions. We present our experience of eight cases of allergic contact dermatitis after tattooing and briefly review the literature on the risks of black henna tattoos.

Guerrillero Heroico--a lasting impression.

What once was simply a cultural tradition is fast becoming a popular phenomenon amongst Western tourists. Temporary henna tattoo designs performed by street or beach vendors are prevalent throughout the Middle East and Asia, particularly in holiday resorts. The public may be mistaken in thinking that the fashionable trend comes without significant risk. The main ingredient in the temporary tattooing method is henna (Lawsonia inermis), a flowering plant with dyeing properties that takes only several hours to be absorbed but provides an effect lasting around ten to fifteen days on the recipient's skin. The side effects of henna tattoos are well documented in the literature, although it is not clear whether the side effects directly relate to the henna ingredient or the additives used to prolong the designs. The most commonly noted complications include allergic contact dermatitis, infection, hypertrophic and keloid scarring and temporary or permanent hypo- or hyperpigmentation. In very rare cases, type 1 hypersensitivity reactions (angioedema and anaphylaxis) have been reported. The following case report highlights several of these complications and the relevant management.

Severe type IV hypersensitivity to 'black henna' tattoo.

A 16-year-old Bangladeshi girl presented with a 9-day history of an extensive pruritic, erythematous, papulovesicular skin eruption to both forearms. Appearance was 5 days following application of a home-made henna preparation. Examination revealed ulceration and scabbing along the whole henna pattern and early keloid formation. A diagnosis of type IV delayed hypersensitivity reaction superimposed by infection was initially made. As in this case, home-made henna preparations commonly combine commercial henna with black hair dye, paraphenylenediamine (PPD). PPD, widely known as 'black henna', darkens the pigment and precipitates the drying process. PPD is a potent contact allergen associated with a high incidence of hypersensitivity reactions. Despite treatment the patient was left with extensive keloid scarring in the pattern of the henna tattoo.

Dermatitis alérgica de contacto por tatuajes temporales de henna negra / Allergic contact dermatitis for temporary black henna tattoos

Cada vez es más frecuente la realización de seudotatuajes de henna de color negro en la población pediátrica y la incidencia de efectos adversos se incrementa significativamente. La henna negra no existe de forma natural; se obtiene a partir de la henna original por añadido de otros compuestos, entre ellos, la parafenilendiamina (PPD), que oscurece y facilita mayor precisión en el dibujo del tatuaje. La PPD posee un gran poder sensibilizante y es un conocido inductor de dermatitis alérgicas de contacto. Puede ocasionar reacciones locales persistentes, secuelas por hiperpigmentación/hipopigmentación, así como futuros problemas debido a que se encuentra presente en múltiples productos de la vida cotidiana. Presentamos el caso de una niña de 11 años con dermatitis alérgica de contacto a tatuaje de henna negra con pruebas epicutáneas positivas para PPD, para alertar sobre el riesgo de estetipo de seudotatuajes.

Temporary ‘black henna’ tattoos, an increasingly popular body decoration in pediatric population, are associated witha growing incidence of adverse events. Black henna does not exist naturally, it is obtained from original henna after the addition of other compounds, among them paraphenilendiamine (PPD), which serves to darken the tattoo and allows greater precision to the design. PPD is known to be a strong sensitizerand increases the risk of allergic contact dermatitis. They may present as long lasting local reactions, and pigmentarysequels apart from problems with the future use of many products present in the daily life, as a result of sensitization by PPD. We report the case of an eleven-year old girl with an allergiccontact dermatitis to black henna tattoo with a positive patch test to PPD, in order to warn against these types of temporary tattoos.

Dermatitis de contacto alérgica por tatuaje de henna / Allergic contact dermatitis from henna tattoo

Se presenta un caso de reacción de contacto por la realización de un tatuaje de henna en un paciente pediátrico y se alerta sobre las posibles complicaciones a corto y largo plazo de este procedimiento. Se trata de una niña de 12 años de edad que presentó una dermatitis de contacto después de haberse realizado un tatuaje temporario de henna. Realizó tratamiento con corticoide tópico con mejoría gradual y posterior aparición de una mácula hipocrómica residual post inflamatoria. El test epicutáneo realizado fue positivo para la parafenilenodiamina. La moda del tatuaje de henna se ha hecho común en la edad pediátrica y muchos casos de dermatitis por contacto por henna han sido descriptos en niños. Este procedimiento produce reacciones locales persistentes, erupciones símil eritema multiforme y secuelas pigmentarias, así como problemas con la futura utilización de las tinturas para el cabello debido a la sensibilización a la parafenilenodiamina. Consideramos que la comunicación de este caso es de importancia para alertar al pediatra y al dermatólogo sobre las posibles complicaciones de este procedimiento.

We present a pediatric case of contact reaction to henna tattoo, alerting of the possible short and long-term complications of this kind of procedure. We describe a 12-year-old girl with a contact dermatitis after applying a temporary henna tattoo. There was gradual improvement with the use of topical corticosteroid and evolution to residual hypochromy. Patch test was positive to paraphenilenodiamine. "Temporary tattomania" with henna is getting to the pediatric population and many cases of henna contact dermatitis have been described in children. They may present as long lasting local reactions, erythema multiform-like lesions and pigmentary sequels apart from problems with the future use of hair dyers as a result of sensitization by paraphenilenodiamine. Thus we believe that the presentation of this case is an opportunity to inform the pediatricians and dermatologists about the possibility of these complications.