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The human eye has a specialized microbiota that reflects its unique anatomical and immunological environment. This low-biomass microbial community predominantly colonizes the conjunctiva and eyelid margins, playing a vital role in ocular surface homeostasis and defense. Despite its proximity to the richly colonized facial skin, the ocular surface maintains a distinct microbial profile due to continuous mechanical and biochemical defense mechanisms.The conjunctival surface hosts fewer microbial...

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Contact blepharoconjunctivitis due to black henna--a case report.

Alicja Pas-Wyroślak1, Marta Wiszniewska, Beata Kręcisz

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Para-phenylenediamine (PPD) in hair dye caused severe eye swelling and eyelid narrowing. This case highlights PPD allergy, leading to contact blepharoconjunctivitis and tear eosinophilia.

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Area of Science:

  • Allergy and Immunology
  • Dermatology
  • Ophthalmology

Background:

  • Para-phenylenediamine (PPD) is a common allergen known to cause hypersensitivity reactions.
  • Hair dyes, particularly those containing henna, are frequent sources of PPD exposure.
  • Contact blepharoconjunctivitis (CB) is an inflammatory condition affecting the eyelids and conjunctiva.

Observation:

  • A 48-year-old female presented with facial edema, including the forehead, cheeks, and eyes, causing significant narrowing of the palpebral fissure.
  • The patient reported recent eyelash and eyebrow dyeing with henna at a beauty salon.
  • Initial skin prick tests (SPT) for common allergens were positive, but SPT for PPD was negative.

Findings:

  • Patch testing confirmed a positive reaction to PPD.
  • Eosinophilia was detected in the patient's tear fluid.
  • This represents the first reported case of PPD-induced CB with concurrent increased tear eosinophilia.

Implications:

  • This case underscores the importance of considering PPD as a potential allergen in delayed hypersensitivity reactions, even with negative skin prick tests.
  • Accurate diagnosis of PPD allergy is crucial for managing contact blepharoconjunctivitis and preventing recurrent exposure.
  • The presence of tear eosinophilia may serve as a diagnostic marker for PPD-induced ocular allergic reactions.