Challenging Interpretation of Blistering Patch Test Reaction in Hair Dye Induced Allergic Contact Dermatitis with Cross-Reaction: A Case Report

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Published: Sep 30, 2025
DOI: https://doi.org/10.47836/mjmhs.21.5.50
Keywords:
Allergens, Dermatitis, Hair dyes, 4-phenylenediamine, Patch Test

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Ho Wen Chung
Unit of Dermatology, Department of Medicine, Faculty of Medicine and Health, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
How Kang Nien
Unit of Dermatology, Department of Medicine, Faculty of Medicine and Health, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
Nurafiqah Farhana Muhammad Yazid
Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Bandar Baru Nilai, 71800 Nilai, Negeri Sembilan, Malaysia

Abstract

Hair dye contact allergy is an emerging public health concern globally, including in Malaysia. Para-phenylenediamine (PPD), an aromatic amine commonly found in hair dyes and henna tattoos, is a well-known allergen contributing to these reactions. This report discusses a case of PPD-induced contact dermatitis, complicated by a blistering reaction following a patch test with PPD 1% in petrolatum. The case highlights the challenges dermatologists face in accurately interpreting patch test results, particularly in the presence of multiple cross-reactions involving PPD, also include the mechanimse of cross reaction and novel hairdye compound investigated with lower cross reaction rate.

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How to Cite
Ho Wen Chung, How Kang Nien, & Muhammad Yazid, N. F. (2025). Challenging Interpretation of Blistering Patch Test Reaction in Hair Dye Induced Allergic Contact Dermatitis with Cross-Reaction: A Case Report. Malaysian Journal of Medicine and Health Sciences, 21(5), 435–437. https://doi.org/10.47836/mjmhs.21.5.50
Issue
Vol. 21 No. 5 (2025)
Section
Case Report
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References

How KN, Tang MM, Kaur R, Johar A. Contact sensitization in adults: a 5-year retrospective review in hospital Kuala Lumpur. Med J Malaysia. 2017 Apr;72(2):113-118. Available from: https://pubmed.ncbi.nlm.nih.gov/28473674/

Ho SG, White IR, Rycroft RJ, McFadden JP. A new approach to patch testing patients with para-phenylenediamine allergy secondary to temporary black henna tattoos. Contact Dermatitis. 2004 Oct;51(4):213-4. doi: 10.1111/j.0105-1873.2004.0424d.x.

Geier J, Ballmer-Weber BK, Dickel H, Frosch PJ, Bircher A, Weisshaar E, Hillen U. Monitoring contact sensitization to p-phenylenediamine (PPD) by patch testing with PPD 0.3% in petrolatum. Contact Dermatitis. 2013 Jul;69(1):26-31. doi: 10.1111/cod.12075.

Wulferink M, Dierkes S, Gleichmann E. Cross-sensitization to haptens: formation of common haptenic metabolites, T cell recognition of cryptic peptides, and true T cell cross-reactivity. Eur J Immunol 2002; 32:1338–48. doi: 10.1002/1521-4141(200205)32:5<1338::AID-IMMU1338>3.0.CO;2-4.

LaBerge L, Pratt M, Fong B, Gavigan G. A 10-year review of p-phenylenediamine allergy and related para-amino compounds at the Ottawa Patch Test Clinic. Dermatitis. 2011 Nov-Dec;22(6):332-4. doi: 10.2310/6620.2011.11044.