[Systemic toxicity of paraphenylenediamine. 4 cases]

Paraphenylenediamine (PPD) poisoning has been known for many years, but few studies have been devoted to the subject. We report 4 cases, seen in the nephrology department, concerning women aged from 18 to 35 years who had tried to commit suicide by drinking varying amounts of that hair dye. The initial symptom was acute asphyxia which required emergency tracheotomy in 3 cases. Thereafter, the most important visceral damage was acute renal failure, usually with oliguria or anuria, for which haemodialysis was performed in 2 cases. In these patients treated at an early stage the mid- and long-term prognosis was satisfactory. Rhabdomyolysis is the principal mechanism underlying PPD systemic toxicity; it is, in particular, responsible for the renal failure observed. The selling of PPD hair dye should be restricted by law.