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Occupational mimics of rheumatoid arthritis: hair dye-induced arthritis

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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.

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Authors and Affiliations

  1. Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece

    E. Pelechas, P. V. Voulgari & A. A. Drosos

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  1. E. Pelechas
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  2. P. V. Voulgari
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  3. A. A. Drosos
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Correspondence to A. A. Drosos.

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Pelechas, E., Voulgari, P.V. & Drosos, A.A. Occupational mimics of rheumatoid arthritis: hair dye-induced arthritis. Rheumatol Int 41, 795–797 (2021). https://doi.org/10.1007/s00296-020-04748-5

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