Occupational mimics of rheumatoid arthritis: hair dye-induced arthritis
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Rheumatology International https://doi.org/10.1007/s00296-020-04748-5
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Occupational mimics of rheumatoid arthritis: hair dye‑induced arthritis E. Pelechas1 · P. V. Voulgari1 · A. A. Drosos1 Received: 5 October 2020 / Accepted: 31 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Hair dye (HD) and its component para-phenylenediamine (PPD) are commonly used to enhance beauty and youth. HD is associated with allergic contact reactions and the development of autoimmune phenomena. A 28-year-old woman presented to us complaining of pain and swelling affecting the small joints of the hands bilaterally lasting for 7 weeks. Laboratory evaluation was remarkable only for an increase of acute-phase reactants, while the rest of laboratory tests including serological tests for viruses, as well as immunological tests were negative or within normal limits. She noticed a close correlation between the onset of symmetrical polyarthritis and the use of HD product. Thus, after excluding other possibilities of inflammatory arthritides, the diagnosis of HD-induced arthritis was made. The patient was treated with naproxen, and after 3 weeks, she had a complete clinical response with decrease of acute-phase reactants. Thus, we review and discuss the relevant literature of cases related with the use of HD and arthritis development. This is the first described case of HD-induced arthritis. Physicians must be aware and recognize these symptoms and signs of patients exposed to HD and treat them appropriately. Keywords Hair dye · Para-phenylenediamine · Arthritis · Autoimmune phenomena · NSAIDS
Introduction Hair dye (HD) products are commonly used by both sexes to enhance beauty and youth. HD and its components like paraphenylenediamine (PPD) are associated with allergic contact reactions and an increased risk for the development of autoimmune rheumatic diseases (ARD), like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) [1–4]. Here, we present a young woman who developed symmetrical polyarthritis affecting the small joints at the hands after the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00296-020-04748-5) contains supplementary material, which is available to authorized users. * A. A. Drosos [email protected] E. Pelechas [email protected] http://www.rheumatology.gr P. V. Voulgari [email protected] 1
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece
use of HD. Informed consent has been provided and signed by the patient. This is an interesting cause of symmetrical polyarthritis in an occupation that is very popular throughout the globe. It is also difficult to correlate it as a causative agent and patients may get treatments that will not alleviate their symptoms. Thus, we review and discuss the relevant literature [5]. To this end, we have searched through PubMed and Scopus using the following words: “hair dye” AND “autoim
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