Phenylenediamine Poisoning: Beyond the Respiratory Distress

The paraphénylèdiamine or PPD is a black coloring agent entering the composition of hair colorings, essentially used in hairstyle as dye for hair, but also in the temporary tattoos, in association with the henna. It is mainly met in coloring them with bottoms (stockings), with shoe polishes, with rubbers, with shoes, with capillary dyes (not exhaustive list) The PPD, extremely sensitizing, can cause very significant allergic reactions that may develop life-threatening immediately by installing an acute respiratory distress, then the occurrence of rhabdomyolysis with risk of acute renal failure. These complications are two conventionally known by the clinician. Nevertheless, the occurrence of myocarditis, often overlooked, is a very serious complication, to raise with clinical signs of shock or in the presence of a rhythm disorder. We report the case of a 28 year old patient hospitalized for management of acute respiratory distress following the acquisition of PPD, whose evolution was marked by the occurrence of myocarditis confirmed by cardiac MRI.