Hypertrophic allergic contact dermatitis from hair dye

We report a case of hypertrophic allergic contact dermatitis probably due to p-phenylenediamine (PPDA) in a 26-year-old female, which developed at the sites of application of a black hair dye to the skin. Histological examination revealed an eczematous process. The lesions subsided completely except for leukoderma that remained on the leg. Patch tests showed positive reactions to PPDA, p-aminophenol and Disperse Orange 3. PPDA, which was one of the components of the dye, was considered to be the primary sensitizer because it was the only substance able to reproduce at the patch test site both the hypertrophic pattern and the permanent leukoderma found in the patient's lesions. To explain the difference in reaction between PPDA and the other 2 para-group substances, we speculate that they are due to different quantities of reactive intermediates, oxidation products and free radicals, produced by these substances.