Temporary henna tattoo reactions in children

Abstract

Case 1 A 9‐year‐old girl applied a temporary henna tattoo to her right arm and 1 week later repeated the same process. In the following 2 days, erythema and papulovesicular eruptions developed at the application site ( Fig. 1 ). Patch tests were performed with the European Standard Series, specific hairdressing agents, and commercial and natural henna. The patient showed a 3+ reaction to both natural henna and ‘‘ para ‐phenylenediamine (PPD)’' 1% and a 3+ reaction to nickel sulfate 5% at 48, 72, and 96 h ( Fig. 2 ). She was treated with topical steroid cream (beclomethasone dipropionate), applied twice daily. A slight postinflammatory hypopigmentation was observed at the time of the patch test. The hypopigmentation has gradually decreased in severity over time ( Fig. 3 ). Case 1: temporary henna tattoo reaction with papulovesicular eruptions image Case 1: patch test results. (A) 3+ reaction to nickel sulfate 5%; (B) 3+ reaction to para‐phenylenediamine (PPD) 1%; (C) 3+ reaction to natural henna image Case 1: postinflammatory hypopigmentation image Case 2 An 11‐year‐old boy was admitted to our outpatient clinic with itchy, erythematous, papulovesicular eruptions on the left arm. These lesions appeared after application of a temporary henna tattoo with a ‘‘do‐it‐yourself’' kit to the left arm. Patch tests were performed with the European Standard Series and commercial tattoo products. The patient showed only a 1+ reaction to commercial henna. He was treated with topical steroid cream (beclomethasone dipropionate), and 2 weeks later his lesions had totally disappeared. Case 3 A 12‐year‐old girl applied a temporary henna tattoo to her left arm. Several hours later, erythema, edema, and itching developed. Patch tests were performed as for Case 2. The patient showed a 2+ reaction to commercial henna. Topical steroid cream (beclomethasone dipropionate) was effective, and 3 weeks later the lesions had healed with slight hypopigmentation. The postinflammatory hypopigmentation traced the tattoo design exactly, which was in the form of a fish ( Fig. 4 ). On follow‐up, the hypopigmentation was not permanent. Case 3: fish‐shaped postinflammatory hypopigmentation image