Hair Dye (Paraphenylenediamine) Poisoning

Prakash C. Vaghela; Naresh B. Gohel

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Prakash C. Vaghela, Naresh B. Gohel.

Kalarav Children hospital, Kushal neonatal nursery, Bhavnagar, Gujarat, India.

ADDRESS FOR CORRESPONDENCE
Dr Prakash C Vaghela, Kalarav children hospital, Kushal neonatal nursery, Akar complex, Opp. Sir T Hospital, Bhavnagar 364001, Gujarat, India
Email: prakash_vghl@yahoo.co.in

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Keywords

Hair dye, Paraphenylenediamine, Angioneurotic edema

Hair dye is composed of paraphenylenediamine. Para-phenylenediamine (PPD) is mixed with henna, which is traditionally applied to color the palms, soles and hair. Toxicity of ppd consists of local skin irritation, contact dermatitis, chemosis, and blindness. Systemic side effects are angioneurotic edema, in later phase rhabdomyolysis, acute renal failure, and convulsions. We report a case of accidental ingestion of ppd who presented with angioneurotic edema requiring tracheostomy. Eighteen months old male child presented with accidental ingestion of hair dye followed by swelling of face, neck, tongue and difficulty in breathing within six hours. On examination, the child was irritable, had pulse of 190/min, respiration was laboured and there was cyanosis. There was edema of face, neck, pharynx and tongue. Investigations showed hemoglobin of 9.8gm%, white cell count of 14,500/cumm (86% polymorphs, 10% lymphocytes), SGPT of 324 IU/L and normal renal function tests, electrolytes, CPK, LDH and urine analysis.

The lethal dose of ppd is 7-10gm. Treatment is mainly supportive. No specific antidote is available. For upper airway obstruction, emergency tracheostomy may be needed. Maintenance of hydration, oxygenation, and adequate urine out put are essential. Intravenous corticosteroids and antihistamines have been tried.

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Funding None

Conflict of Interest None

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