Allergic reactions to decorative skin paintings.

BACKGROUND: Dye mixtures containing henna, P-phenylenediamine (PPD), and indigo are applied to the skin in various parts of the world for religious purposes, social recognition or fun. AIM: To identify eventual allergens responsible for contact sensitization to skin decoration in three young children. Lesions remained strictly limited to the site painted during the summer holiday. None of the children had a previous history of contact dermatitis, but two of them suffered from severe seasonal allergic rhinoconjunctivitis. FINDINGS: Patch testing revealed severe contact hypersensitivity to PPD in all three patients, and one child presented a positive prick test to 1% henna in water. The eruptions resolved following spontaneous elimination of the dyes and topical applications of corticosteroids, but left residual depigmentation. CONCLUSION: PPD is the main allergen identified in allergic reactions to decorative skin paintings.