Black henna tattoo: Beyond the contact dermatitis

Henna is used as a hair dye and to make temporary tattoos on the skin. It is frequently mixed with paraphenylenediamme (PPD). Contact dermatitis following the application of temporary paint-on henna tattoos indicates a potentially serious problem of active sensitisation. Sensitisation to PPD may also cause sensitivity to clothing dyes, hair dyes and local anaesthetics. We report the case of a young woman with a history of contact dermatitis caused by a black henna tattoo, who presented swelling of her lips after local application of benzocaine gel. Epicutaneous tests were positive for PPD, orthonitroparaphenylenediamine. benzocaine and procaine, probably related to cross-reactions between PPD and these three molecules. (C) 2009 Elsevier Masson SAS. All rights reserved.