From cosmesis to crisis: early airway protection in PPD poisoning

Vasmol, a commonly used hair dye containing paraphenylenediamine (PPD), has emerged as a potential toxic agent when ingested. Easy availability and cheap price make it easily accessible for self-harm purposes. The present case report describes the lethal presentation of the ingestion of the Vasmol dye and highlights the critical importance of early airway management in a woman who presented with respiratory distress and cervico-facial oedema along with systemic toxicity and multiorgan involvement. Despite tracheostomy and best resuscitative efforts, the patient succumbed due to systemic toxicity. Early recognition, airway management and comprehensive monitoring for systemic toxicity (cardiac, renal and liver) may improve prognosis as no specific antidote exists and treatment is supportive care.