Temporary henna tattoo reactions in children

Case 1 A 9-year-old girl applied a temporary henna tattoo to her right arm and I week later repeated the same process. In the following 2 days, erythe ma and papulovesicular eruptions developed at the application site (Fig. 1) . Patch tests were performed with the European Standard Series, specific ha irdressing 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 tre ated with topical steroid cream (beclomethasone dipropionate), applied twic e daily. A slight postinflammatory hypopigmentation was observed at the tim e of the patch test. The hypopigmentation has gradually decreased in severi ty over time (Fig. 3). Case 2 An 11-year-old boy was admitted to our outpatient clinic with itchy, erythematous, papulovesicular eruptions on the left arm. These lesions app eared 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 2+ reacti on to commercial henna. He was treated with topical steroid cream (beclomet hasone 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 w ere 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 w as in the form of a fish (Fig. 4). On follow-up, the hypopigmentation was n ot permanent.