Prevalence of Contact Allergy to p-Phenylenediamine in the European General Population

February 2016Volume 136, Issue 2, Pages 409–415

Thomas L. Diepgen

,

 Luigi Naldi

,

 Magnus Bruze

,

 Simone Cazzaniga

,

 Marie-Louise Schuttelaar

,

 Peter Elsner

,

 Margarida Goncalo

,

 Robert Ofenloch

,

 Åke Svensson

DOI: http://dx.doi.org/10.1016/j.jid.2015.10.064

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Population-based studies on contact allergy to p-phenylenediamine (PPD) are scarce. A cross-sectional study was performed to assess the prevalence of contact allergy to PPD and its risk factors in the general population of 5 European countries. A total of 10,425 subjects were interviewed, and a random sample (n = 2,739) was patch tested to PPD. Overall, 5,286 individuals (50.9%) reported having used hair colorants at least once in their lifetime (78% female, 20% male), and 35% had used hair colorants during the last 12 months. Hair colorant avoidance because of any skin problem during the lifetime was reported by 6%.

Black henna tattoos had been used by 5.5% during their lifetime. The prevalence of PPD contact allergy was 0.8% (95% confidence interval 0.6–1.0%), with no statistically significant association with gender or hair dye use. The prevalence of PPD in black henna tattoo users was 3.2% versus 0.6% in nonusers (P < 0.001). A clinically relevant positive patch test reaction to PPD related to hair coloring products was found in 0.1% (95% confidence interval 0.0–0.2%). A significant association with PPD contact allergy was observed for subjects who had black henna tattoos in their lifetime, with an age- and gender-adjusted odds ratio of 9.33 (95% confidence interval 3.45–25.26, P < 0.001). Black henna tattoos are an important risk factor for PPD contact allergy.

Abbreviations:

CI (confidence interval), EDEN (European Dermato-Epidemiology Network), IVDK (Information Network of Departments of Dermatology), OR (odds ratio), PPD (p-phenylenediamine)

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