Enter the dragon!

The pattern of a dragon was the imprint of temporary tattoos received whilst on holiday in Bali, Indonesia. On the right, the reaction developed over 1 week (Fig. 1b). A more intense reaction within 24 h occurred to the tattoo on the left placed several days after that on the right (Fig. 1a). The first lesion showed hypertrichosis (Fig. 1c). Dermatitis associated with temporary black henna tattoos is most often caused by delayed type hypersensitivity to p‐phenylenediamine (PPD). PPD is a dye and drying agent added to red henna that is commonly used in traditional religio‐cultural body art. In this boy, sensitisation occurred with placement of the first tattoo predisposing him to a rapid reaction following placement of the second. PPD sensitisation can result in allergic reactions to other PPD containing materials (e.g. hair dyes, textiles, inks and paints). Furthermore, hypersensitivity to PPD is associated with cross‐reactivity to a large number of related chemicals used in cosmetics (e.g. toluene‐2,5‐ diamine sulphate) and textiles as well as medicines (e.g. local anaesthetics: benzocaine, procaine) with potential future health or employment implications.