Allergic contact dermatitis caused by a black permanent marker.

A 20-year-old female dental assistant experienced an acute dermatitis at the site of a temporary ‘henna’ tattoo that had been applied 3 days earlier. It transpired that ‘henna’ tattoos had been applied on previous occasions. After the above episode, she subsequently developed eczematous reactions on the face, neck and upper back within a few days of dyeing her hair with dark brown or black colour on two occasions. She therefore stopped using hair dye. On a later occasion, she drew small figures on the backs of her fingers with a black permanent marker. A few days later, she developed linear pruritic erythematous dermatitis exactly at the site of these lines. The eruptions persisted for 1 week (Fig. 1). Patch testing was performed (with 8 mm Finn Chambers® on Scanpor® tape) with an extended European baseline series, including diluted p-phenylenediamine (PPD), Disperse Orange 3, and caine series. Tests were read at days 2 and 4 according to the recommendations of the International Contact Dermatitis Research Group, and the results are summarized in Table 1 and Fig. 2.