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Clinicopathologic Features of Skin Reactions to Temporary Tattoos and Analysis of Possible Causes
Wen-Hung Chung, MD;
Ya-Ching Chang, MD;
Lih-Jen Yang, MD;
Shuen-Iu Hung, PhD;
Wen-Rou Wong, MD;
Jing-Yi Lin, MD;
Heng-Leong Chan, MD
Arch Dermatol. 2002;138:88-91.
Background Recently, temporary paint-on tattoos have become increasingly popular
as a safe alternative to permanent tattoos in Asia and other regions. The
most common dye for such temporary tattoos is henna, a vegetable dye. Henna
is considered to possess low allergenicity because the incidence of allergic
contact dermatitis to henna has rarely been reported. However, recently, allergic
reactions to henna used in temporary tattoos have been reported frequently.
Observations Ten patients developed inflamed skin eruptions after receiving temporary
paint-on tattoos in either Thailand or Indonesia. The 6 patients who were
patch tested all exhibited moderate to strong positive reactions to p-phenylenediamine (1% in petrolatum). Four of the 6 patients
were then tested with commercial black henna obtained from Thailand, and all
4 had strong positive reactions. A skin biopsy specimen showed lichenoid dermatitis.
Mass spectrometry analysis of commercial black henna for molecular weight
revealed a major peak at the mass-charge ratio of 108.1, which corresponds
to the molecular weight of p-phenylenediamine.
Conclusions The most likely causative agent for the lichenoid reaction associated
with use of commercial black henna for temporary tattooing, currently popular
in Southeast Asia, is p-phenylenediamine. With the
increased popularity of temporary paint-on tattoos, clinicians should be aware
of the possible associated complications.
From the Department of Dermatology, Chang Gung Memorial Hospital (Drs
Chung, Chang, Yang, Wong, Lin, and Chan), and the Institute of Microbiology
and Immunology, National Yang-Ming University (Dr Hung), Taipei, Taiwan.
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Arch Dermatol. 2002;138(1):139.
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