Clinical and experimental study of acute intoxication as a result of ingestion of stone hair dye containing paraphenylenediamine

Hair dyes containing para-phenylenediamine were used in some communities for criminal purposes and more frequently for attempted suicide and sometimes accidentally ingested. The aim of the present work to analyze the various aspects of poisoning fatalities as a result of stone hair dye [SHD] ingestion through a retrospective study of fatalities investigated by Assiut Chemical Laboratory of Medico-legal Department, Ministry of Justice in four governorates in Upper Egypt and to detect the systemic effects on experimental animals as a result of its ingestion and if there is dose-effect relationship. The records of acute poisoning cases of hair dye ingestion investigated by Assiut Medicolegal Laboratory in the period from January 2002 to December 2009 were examined as regarding type of poison, pattern, incidence, sex, geographical distribution and mode of poisoning. The studying of the systemic effects on ingestion of hair dye was conducted on 30 albino rats divided into five groups each contain 6 animals. The first group was the control and the other groups were subjected to oral administration of either stone hair dye or para-phenylenediamine [PPD] in two doses [10 and 20 mg each]. The animals were sacrificed after 24 hours and haematological, histopathological [liver and kidney] and biochemical examinations were performed. The results obtained from the records revealed that 72.29% of the cases were from Qena, 14.45% from Aswan, 12% from Sohag and 1.2% from Assiut. The highest incidence of poisoning was found in 2006 [19.3%] followed by 2008, 2009 [15.7%] each, then 2004 and 2005 [13.3%], 2007 [12%], 2002 [7.2%] and lastly 2003 [3.6%]. The majority of victim's were females and most of cases were suicides. There were insignificant changes in RBCs count in all groups and insignificant decrease of Hb concentration while WBCs count was very significantly increased. The levels of AST and ALT showed a significant increase in all treated groups while serum level of creatinine was insignificantly decreased. There was significant increase in the plasma enzymes AST, GPT, the liver tissues showed many degenerative changes in the form of vacuolated cytoplasm and irregular deeply stained nuclei of the hepatocytes with vascular congestion and lymphocytic infiltration. The same results were obtained with both SHD and PPD. They were more obvious with high doses of both. The results confirmed that Para-phenylenediamine is the main toxic ingredient in stone hair dye, and the experimental study revealed that the liver is the target organ of para-phenylenediamine and SHD toxicity, also that toxic manifestations were dose related. This compound is highly toxic when taken by mouth and the outcome depends mainly on the dose taken. The study recommends that the sale and use of PPD containing dyes, SHD and henna should be prohibited

Nail changes in minimal alopecia areata

Nail involvement in alopecia areata is relatively common. The reported incidence ranged from 10 to 66%, and in another it was as low as 3.65%. Onychodystrophy generally is most common and severe in patients with extensive alopecia, but it has been reported with minimal hair loss. This work aimed at evaluating the types and the prevalence of nail changes occurring in the patchy type of alopecia areata with minimal hair loss. Eighty four patients with patchy type of alopecia areata of minimal hair loss were included in this study. Full clinical examination and pertinent laboratory investigations were done for them. 44.1% of patients presented with nail changes; 36.84% had maturity onset and 59.25% had juvenile onset alopecia areata. 48.27% gave history of recurrence of alopecia areata. Fine pitting occurred in 32.43%, fine pitting with longitudinal ridging in 24.32%, longitudinal ridging alone in 8.11%, punctuate Leukonychia in 16.22%, Beau's lines in 10.81%, onycholysis and nail shedding in 5.41%, and reddening of the nail in 2.70% of patients. Nail changes are common in alopecia areata, occurring even in mild cases with minimal hair loss, being more with longer duration and recurrence. Children and adolescents are more prone to nail changes than adults. Diffuse fine pitting and longitudinal ridging are the commonest nail affection

Treatment of post transplantation kaposi's sarcoma with interferon

Kidney transplanted patients under the immunosuppressive therapy are at risk of acquiring Kaposi's sarcoma [KS]. A 26 years old Somali male patient developed KS [10 months after renal transplantation] whilst on cyclosporin A, azathioprine and prednisolone. The clinical diagnosis of KS was confirmed by the biopsy. There was no lymphadenopathy nor visceral involvement. The patient received recombinant alpha 2a interferon in an subcutaneous injection of 6 million units three times weekly for three months [36 injections]. The KS regressed gradually and disappeared completely with brownish pigmented skin. Now, after more than 20 months, the patient is well with a well functioning graft and there is no recurrence of the KS inspite of the patient is still on the same immunosuppressive therapy