The use of temporary natural henna painting for body adornment and hair dyeing is very common in several countries of the Indian subcontinent, Middle East, and North Africa, and the
fad is spreading in other parts of the world. Several cases of
para-phenylenediamine (
PPD) contaminated, temporary traditional/natural henna induced sensitization and acute
allergic reaction have been reported, along with occasional serious long term and rare fatal consequences. We report here a 17-year-old girl with
blisters over her hands of five-days duration that appeared within 72 hours of applying a temporary henna paint to her hands during a social occasion. Similar lesions were noted on her face. She had previously applied
black henna only once, a year earlier without developing any lesions. Clinical diagnosis of acute
allergic contact dermatitis (ACD) was made. After a short course of oral
corticosteroids, topical
mometasone furaote 1.0% cream, and oral
antihistamines, the lesions healed completely over the next four weeks leaving post-inflammatory
hypopigmentation. Patch testing done with standard European battery,
PPD 1% in
petrolatum, and commercially available natural henna
powder revealed a 3+ reaction to
PPD at 48 hours. No reaction was seen at the natural henna site. Awareness of the condition among physicians and the public and regulation regarding warnings of the risks of using such products is urgently warranted.