Ann Dermatol.  2018 Jun;30(3):316-321. 10.5021/ad.2018.30.3.316.

P-Phenylenediamine Hair Dye Allergy and Its Clinical Characteristics

Affiliations
  • 1Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. jylee@catholic.ac.kr

Abstract

BACKGROUND
P-phenylenediamine (PPD) has been identified as the most frequent contact sensitizer of hair dye and the clinical characteristics of hair dye contact allergy (HDCA) are diverse.
OBJECTIVE
The purpose of this study was to identify the clinical characteristics of HDCA and to assess the relationships between HDCA, exposure time to PPD and PPD positivity.
METHODS
We analyzed 105 patients with patch test-confirmed hair dye allergy who presented between July 2009 and March 2015. Clinical symptoms, signs, associated skin diseases, involved ACD area, and patterns of hair dye use were obtained by reviewing medical records and by interview.
RESULTS
HDCA was more common in women and in individuals aged more than 50 years. Pruritus was the most common symptom; erythematous macules and patches were the most frequently observed clinical signs. The most common site of HDCA was the face and non-specific eczema and urticaria were frequently observed with HDCA. Exposure time to hair dye, represented as frequency and duration, showed a positive correlation with the area affected by hair dye allergy (p < 0.001). Hair dye allergy was identified in most patients (80%) before diagnosis by patch test. However, only 28.6% of all patients stopped using hair dye, even after the diagnosis was confirmed.
CONCLUSION
The extent of hair dye allergy involvement was related to exposure time to hair dye. For effective treatment of HDCA, it is important to properly educate patients with HDCA about the clinical manifestations of HDCA and to keep away from allergens.

Keyword

Allergic contact dermatitis; Hair dyes; Phenylenediamines

MeSH Terms

Allergens
Dermatitis, Allergic Contact
Diagnosis
Eczema
Female
Hair Dyes
Hair*
Humans
Hypersensitivity*
Medical Records
Patch Tests
Phenylenediamines
Pruritus
Skin Diseases
Urticaria
Allergens
Hair Dyes
Phenylenediamines

Figure

  • Fig. 1 Duration of hair dye use, frequency of hair dye use, P-phenylenediamine (PPD) positivity and combined dermatologic problems. Exposure time to hair dye (duration [years]×frequency [number of applications/year]) and extent of hair dye contact allergy involvement (direct; mean=60.0 and indirect; mean=130.0) showed a statistically significant correlation (p=0.001). Regarding exposure time to hair dye and PPD positivity (weakly positive, mean=116.83; strongly/extremely positive, mean=127.64), no statistically significant relationship was found (p=0.27). Exposure time to hair dye and the presence of combined dermatologic problems (no, mean=128.7; yes, mean=117.4) did not show a statistically significant correlation (p=0.30). HDCA: hair dye contact allergy.


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