Podcast
Questions and Answers
What is the main systemic problem associated with Paraphenylene Diamine (PPD) when it is ingested?
What is the main systemic problem associated with Paraphenylene Diamine (PPD) when it is ingested?
Which clinical symptom is most commonly associated with acute PPD poisoning?
Which clinical symptom is most commonly associated with acute PPD poisoning?
What percentage of PPD poisoning cases lead to acute respiratory insufficiency?
What percentage of PPD poisoning cases lead to acute respiratory insufficiency?
Which treatment is NOT recommended for PPD intoxication?
Which treatment is NOT recommended for PPD intoxication?
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In which age group is PPD intoxication most commonly observed?
In which age group is PPD intoxication most commonly observed?
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What was the average number of PPD intoxication cases per year reported in Khartoum from 1995 to 2005?
What was the average number of PPD intoxication cases per year reported in Khartoum from 1995 to 2005?
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What is the mortality rate range for PPD intoxication?
What is the mortality rate range for PPD intoxication?
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What is the primary cause of PPD poisoning in adults?
What is the primary cause of PPD poisoning in adults?
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Study Notes
Paraphenylene Diamine (PPD) Hair Dye Poisoning
- PPD is a key ingredient in various hair dyes
- Different shades are produced via varying concentrations of PPD
- In Sudan, PPD is used by women to color hair and for dyeing henna (Lawasonia alba)
- PPD's toxicity comes from skin absorption
- It's an allergen; major systemic issues arise from accidental ingestion or during self-harm/homicidal acts
- A toxic dose is 3-5mg
Systemic Poisoning
- Acute PPD poisoning causes characteristic severe facial and neck edema which may require tracheostomy
- Symptoms include: a swollen, dry, hard tongue and/or chocolate brown urine
- PPD intoxication is a multisystem poison causing rhabdomyolysis and acute renal failure (ARF)
- Additional symptoms include: flaccid paralysis, severe gastrointestinal distress, cardiotoxicity and arrhythmias
- Untreated, this form is often fatal
Clinical Presentation
- Common symptoms include:
- Severe edema (94%)
- Acute respiratory insufficiency (56%) requiring tracheal intubation (72%) or tracheostomy (21%)
- Signs of rhabdomyolysis (88%)
- Gastrointestinal symptoms, including abdominal pain (53%)
- Oliguric acute renal failure (32%)
Epidemiology and Patient Population
- PPD intoxication is a significant health concern in Sudan, Morocco, and India
- It is a frequent cause of suicide attempts necessitating hospitalization in Morocco
- In adult cases, 70-90% of PPD poisoning involves suicidal intent
- The mortality rate ranges from 10.6% to 38.7%
- Data from a Khartoum hospital (1995-2005) shows 3159 cases with an average of 287.1 per year.
- The most affected age group is 15-24 years (52%)
- Females are disproportionately affected (80.7%)
- Suicidal intent is the leading cause in most cases (87%)
Treatment and Prevention
- Early recognition, prompt referral, and aggressive supportive treatment can reduce mortality
- No specific antidote is available
Investigation
- Blood tests for PPD
- Urine tests for PPD
- Renal Function Tests (RFT)
- Liver Function Tests (LFT)
- Electrocardiogram (ECG)
Management
- Immediate management should follow ABCs
- Angioneurotic edema and significant respiratory distress may require tracheostomy and mechanical ventilation
- Fluids, gastric lavage, and renal dialysis may be required
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Description
Explore the dangers associated with Paraphenylene Diamine (PPD) found in hair dyes. This quiz covers its toxic effects, clinical presentation, and systemic poisoning symptoms. Understanding PPD's impact is crucial for safe usage and awareness.
