Poisoning Of Paraphenylene Diamine - “Kala Pathar”: Black Stone, A Lethal Suicidal Agent: Mini Review

Authors

  • Masood Ahmed Unar SMBBMU Larkana

DOI:

https://doi.org/10.37762/jgmds.12-3.716

Abstract

OBJECTIVES

To objective of review was to gather the knowledge about the clinical aspects of PPD poisoning as suicidal agent and its treatment and outcomes.

METHODOLOGY

A The data regarding the poisoning cases was collected from  This review shows that PPD poisoning is very lethal, quick treatment can save the mortality and morbidity, poor countries have little sources of research to do over it, so wealthier countries should come forward to invest in creation of antidote and improve the treatment options.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biography

Masood Ahmed Unar, SMBBMU Larkana

Assistant Professor,
Department of Pharmacology,  
SMBBMU Larkana

References

World Health Organization. Public health action for the prevention of suicide: a framework. Geneva: WHO; 2012

Arafat SY. Suicide in Bangladesh: a mini review. Suicide. 2014;3

Brådvik L. Suicide risk and mental disorders. Int J Environ Res Public Health. 2018 Sep 17;15(9):2028 DOI: https://doi.org/10.3390/ijerph15092028

Värnik P. Suicide in the world. Int J Environ Res Public Health. 2012;9(3):760–771 DOI: https://doi.org/10.3390/ijerph9030760

Chen YY, Wu KC-C, Yousuf S, Yip PS. Suicide in Asia: opportunities and challenges. Epidemiol Rev. 2012;34(1):129-44 DOI: https://doi.org/10.1093/epirev/mxr025

Kanchan T. Preferred methods of suicide and most common poisonings in India. Toxicol Int. 2014;21(3):341 DOI: https://doi.org/10.4103/0971-6580.155400

Kar N. Lethality of suicidal organophosphorus poisoning in an Indian population: exploring preventability. Ann Gen Psychiatry. 2006 Nov 21;5:17 DOI: https://doi.org/10.1186/1744-859X-5-17

Khan NU, Khan UR, Feroze A, Khan AR, Ejaz K, Razzak JA. The current state of poison control centers in Pakistan and the need for capacity building. Asia Pac J Med Toxicol. 2014;3(1):31-5

Mashreky SR, Rahman F, Rahman A. Suicide kills more than 10,000 people every year in Bangladesh. Arch Suicide Res. 2013;17(4):387-96 DOI: https://doi.org/10.1080/13811118.2013.801809

Safdar M, Afzal KI, Smith Z, Ali F, Zarif P, Baig ZF. Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades. BJPsych Open. 2021 Jul;7(4):e123 DOI: https://doi.org/10.1192/bjo.2021.923

Prabhakaran ACJ. Paraphenylene diamine poisoning. J Nat Sci Biol Med. 2012;3(2):199-200 DOI: https://doi.org/10.4103/0976-9668.101924

National Center for Biotechnology Information. PubChem Compound Summary for CID 7814, p-Phenylenediamine. PubChem. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/p-Phenylenediamine. [Accessed 2022 Dec 6]

Omer Sultan M, Khan MI, Ali R, et al. Paraphenylene diamine (Kala Pathar) poisoning at the National Poison Control Center in Karachi: a prospective study. Cureus. 2020;12(5):e8352 DOI: https://doi.org/10.7759/cureus.8352

Chaudhary SC, Sawlani KK, Singh K. Paraphenylene diamine poisoning. Niger J Clin Pract. 2013 Apr 1;16(2):258 DOI: https://doi.org/10.4103/1119-3077.110138

Ahmad K. Paraphenylene diamine toxicity – epidemiology and treatment in rural regions of Bahawalpur, Punjab, Pakistan. Toxicol Open Access. 2021;7:152. doi:10.4172/2476-2067.1000152

Gude D, Bansal D, Malu R, Gude J. Paraphenylenediamine: blackening more than just hair. J Res Med Sci. 2012;17(6):584-6

Asghar S, Shah S, Hussain T, et al. Paraphenylenediamine (hair dye) poisoning: a prospective study on the clinical outcome and side effects profile. Cureus. 2022 Sep 13;14(9):e29133 DOI: https://doi.org/10.7759/cureus.29133

Bhowmick D, Bhar K, Mallick SK, Das S, Chatterjee N, et al. Para-phenylenediamine induces apoptotic death of melanoma cells and reduces melanoma tumour growth in mice. Biochem Res Int. 2016;2016:3137010. DOI: https://doi.org/10.1155/2016/3137010

Al-Suwaidi A, Ahmed H. Determination of para-phenylenediamine (PPD) in henna in the United Arab Emirates. Int J Environ Res Public Health. 2010;7(4):1681–93 DOI: https://doi.org/10.3390/ijerph7041681

Abdelraheem M, Hamdouk M, Zijlstra EE. Paraphenylene diamine (hair dye) poisoning in children. Arab J Nephrol Transplant. 2010;3(1):39–44 DOI: https://doi.org/10.4314/ajnt.v3i1.57599

Gowda NR, Kumar GP, Sudarshan RV, et al. Hair-dye-related accidental poisoning and death. Cureus. 2021 Apr 21;13(4):e14607 DOI: https://doi.org/10.7759/cureus.14607

Qasim AP, Ali MA, Baig A, Moazzam MS. Emerging trend of self harm by using ‘Kala Pathar’ hair dye (paraphenylene diamine): an epidemiological study. Ann Punjab Med Coll. 2016;10(1):26–30

Khan MA, Akram S, Shah HB, Hamdani SA, Khan M. Epidemic of Kala Pathar (paraphenylene diamine) poisoning: an emerging threat in southern Punjab. J Coll Physicians Surg Pak. 2018 Jan 1;28(1):44–7 DOI: https://doi.org/10.29271/jcpsp.2018.01.44

Bhagavathula AS, Bandari DK, Elnour AA, Shehab A. A systematic review and meta-analysis of the prevalence and complications of paraphenylenediamine-containing hair dye poisoning in developing countries. Indian J Pharmacol. 2019;51(5):302–15. DOI: https://doi.org/10.4103/ijp.IJP_246_17

Garg SK, Chawla R, Bhalla A, Sharma N, Sood P. Hair dye poisoning: an unusual encounter. Indian J Crit Care Med. 2014;18(6):402–4 DOI: https://doi.org/10.4103/0972-5229.133941

Qurashi HE, Qumqumji AA, Zacharia Y. Acute renal failure and intravascular hemolysis following henna ingestion. Saudi J Kidney Dis Transpl. 2013;24(3):553. DOI: https://doi.org/10.4103/1319-2442.111065

Calogiuri G, Di Leo E, Butani L, et al. Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism? Clin Mol Allergy. 2017;15:8 DOI: https://doi.org/10.1186/s12948-017-0063-6

Shigidi M, Bashir A, Ahmed H, et al. Clinical presentation, treatment and outcome of paraphenylene-diamine induced acute kidney injury following hair dye poisoning: a cohort study. Pan Afr Med J. 2014 Oct 16;19:163 DOI: https://doi.org/10.11604/pamj.2014.19.163.3740

Prabhakaran ACJ. Paraphenylene diamine poisoning. Indian J Pharmacol. 2012;44(3):423–4 DOI: https://doi.org/10.4103/0253-7613.96356

Haqdad M, Qureshi S, Ahmed A. The management of patients presented with black stone poisoning: an experience of a tertiary care hospital. Pak Armed Forces Med J. 2021 Dec 2;71 DOI: https://doi.org/10.51253/pafmj.v71iSuppl-3.7942

Iqbal J, Hussain M, Hussain A, Ghafoor MB. Paraphenylene diamine (Kala Pathar) poisoning: to study the demographic profile, clinical manifestations and outcome at Sheikh Zayed Hospital Rahim Yar Khan. Prof Med J. 2019 May 10;26(5):825–30 DOI: https://doi.org/10.29309/TPMJ/2019.26.05.3484

Rawat R, Kumar M, Singh PS, Kumar G, Verma V. Study of hair dye poisoning and its outcome in tertiary care rural institute. Int J Res Med Sci. 2016 Aug;4(8):3240. DOI: https://doi.org/10.18203/2320-6012.ijrms20162272

Senthilkumaran S, Thirumalaikolundusubramanian P. Acute hair dye poisoning: lurking dangers. J Mahatma Gandhi Inst Med Sci. 2015;20:33–7. DOI: https://doi.org/10.4103/0971-9903.151731

An analysis of the trend of rising in poisoning due to hair dye brand (Super Vasmol 33 Keshkala). The Free Library [Internet]. 2014 [cited 2022 Dec 6]. Available from: https://www.thefreelibrary.com/An+analysis+of+the+trend+of+rising+in+poisoning+due+to+hair+dye+brand...-a0362850004

Ahmad E. Paraphenylene diamine (PPD) poisoning - A case report: Do we really know Kala Pathar? J Anesth Crit Care Open Access. 2018;10(1):00353 DOI: https://doi.org/10.15406/jaccoa.2018.10.00353

Kallel H, Chelly H, Dammak H, et al. Clinical manifestations of systemic paraphenylene diamine intoxication. J Nephrol. 2005 May 1;18(3):308

Khuhro BA, Khaskheli MS, Shaikh AA. Paraphenylene diamine poisoning: our experience at PMC Hospital Nawabshah. Anaesth Pain Intensive Care. 2019 Feb 4:243–6

Abdelraheem M, Ali ET, Hussien R, Zijlstra E. Paraphenylene diamine hair dye poisoning in an adolescent. Toxicol Ind Health. 2011 Nov;27(10):911–3 DOI: https://doi.org/10.1177/0748233711399321

Ali I, Bakhtawar A, Sharief M. Clinical profile and outcomes of paraphenylene diamine (Kala Pathar) poisoning at a tertiary care center, Pakistan

Nautiyal S, Tiwari S, Ashutosh K. Pathar dye (paraphenyldiamine) poisoning: our experience of this lethal emerging health problem in a tertiary care centre. Int J Otorhinolaryngol Head Neck Surg. 2017 Sep 22;3(4):1056–9 DOI: https://doi.org/10.18203/issn.2454-5929.ijohns20174332

Downloads

Published

2025-06-30

How to Cite

Unar, M. A. . (2025). Poisoning Of Paraphenylene Diamine - “Kala Pathar”: Black Stone, A Lethal Suicidal Agent: Mini Review. Journal of Gandhara Medical and Dental Science, 12(3), 68–67. https://doi.org/10.37762/jgmds.12-3.716