Paraphenylenediamine Toxicity

Excerpt

Paraphenylenediamine is an aromatic amine found in Kala Pathar ("black stone"). In its pure form, paraphenylenediamine is a white crystal that oxidizes to a brown or dark brown. Although it is mainly manufactured in Japan, Germany, and the United Kingdom, it is more commonly used for its dyeing properties in parts of East Africa, the Middle East, and the Indian subcontinent. Despite typically being used in traditional customs such as henna, it is emerging as a common household poison and suicide agent, particularly in these regions, possibly due to its affordability, ease of accessibility, and high toxicity.

However, as with all other intoxicants, the potential for toxicity and its expected presentations can vary based on the route of exposure, amount and concentration of exposure, and the duration of exposure. Reports in the literature primarily focus on the 2 most common routes—transdermal and oral ingestion. Transdermal exposure is typically associated with dermatologic complications of varying severity, whereas oral ingestion—often due to accidental ingestion or suicidal intent—particularly in higher dosages, has been shown to cause severe multiorgan toxicity.