PPD Hair Dye Poisoning PDF

Paraphenylene Diamine (PPD) Hair dye poisoning Paraphenylene diamine (PPD) has been used internationally as a key ingredient in different hair dye formulations to produce a variety of shades depending on its concentration  In Sudan PPD is used by women to color their hair and as a d...

Paraphenylene Diamine (PPD) Hair dye poisoning Paraphenylene diamine (PPD) has been used internationally as a key ingredient in different hair dye formulations to produce a variety of shades depending on its concentration  In Sudan PPD is used by women to color their hair and as a dye when added to henna (Lawasonia alba) to color the palms and soles  The toxicity of PPD occurs through skin absorption  It is well known that PPD is an allergen  Its major systemic problem occurs when ingested accidentally, or during self harm or homicidal acts Toxic dose is 3-5mg.  Systemic poisoning Acute poisoning with PPD causes a characteristic: – Severe oedema of the face and neck often requiring tracheostomy, – Swollen dry hard tongue – Chocolate brown color of the urine PPD intoxication is a multisystem poison and can cause rhabdomyolysis and acute renal failure (ARF) Flaccid paralysis, severe gastrointestinal manifestations, cardiotoxicity and arrhythmias were also reported This form of severe intoxication is fatal if not treated aggressively  There is no specific antidote available  Clinical Presentation Clinical symptoms Percentage Oedema 94% Acute respiratory insufficiency 56% - Trachial intubations 72% - Tracheostomy 21% Signs of rhabdomyolysis 88% GIT symptoms (Abdominal pain) 53% Oliguric acute renal failure 32% PPD intoxication is a major health problem in Sudan, Morocco and Indian  Acute PPD poisoning is the most frequent cause of suicidal attempts requiring hospitalization in Morocco  In adult practice 70 – 90% of PPD poisoning is due to suicidal attempts  The mortality rate range between 10.6 -38.7%  Statistics from the ENT teaching hospital in Khartoum from 1995 to 2005 showed PPD intoxication in 3159 patient with an average of 287.1 per year  The common age group affected was 15 - 24 years 52%  There was a predominance of females 80.7%, and the majority of cases 87% were due to suicidal attempts The mortality rate of PPD intoxication can be decreased by early recognition, prompt referral and aggressive supportive treatment.  Investigation -Blood for PPD -Urine for PPD -RFT -LFT -ECG  management - ABC - Angioneurotic edema ………> tracheostomy - Respiratory failure …………> Ventilator - Fluids - Gastric lavage - Renal dialysis