A Prospective Study on the Clinical Profile and Outcome in Hair Dye (Super Vasmol) Poisoning

BACKGROUND: Hair dye poisoning with super vasmol is an emerging problem in the developing parts of the world mainly because of the easy availability of the substance. The active ingredients in the dye which has toxic effects are para-phenylene-diamine, resorcinol, propylene glycol and EDTA sodium. Para-phenylene-diamine is responsible for most of the clinical features of the patients presenting with hair dye poisoning. AIM OF THE STUDY: To study the clinical profile, biochemical profile, complications, management and outcome in hair dye (super vasmol) poisoning. MATERIALS AND METHODS: A prospective study was done on 53 patients over a period of 6 months with patients getting admitted with super vasmol poisoning. Patients with mixed poisoning and hair dye poisoning other than super vasmol poison are excluded from the study. RESULTS: We conducted a prospective study on 53 patients who were admitted in the intensive medical care unit of our hospital. Female predominance was seen. The commonest presentation was dyspnoea with cervicofacial edema followed by myalgia and muscle tenderness. The presence of rhabdomyolysis was evident from the muscle pain, muscle tenderness and elevated total CPK levels. 21 patients developed complications like respiratory distress and acute kidney injury. None of the individuals in the study population developed hepatitis and myocarditis. 13.2% of the patients required hemodialysis, 5.7% needed tracheostomy and 11.3% were subjected to both hemodialysis and tracheostomy. The mortality rate in the study population was 11.3%. patients were treated with supportive treatment mainly intra venous steroids, anti-histaminics and supplemental oxygen. Patients who had evidence of rhabdomyolysis were treated with forced alkaline diuresis. Totally 6 patients expired and the cause of death being respiratory distress and acute kidney injury. CONCLUSION: The initial presentation, volume consumed and biochemical profile correlates directly with severity of the clinical features and the complications. The main complications were acute respiratory distress and acute kidney injury and these also being the common cause of mortality. The treatment is mainly supportive and treatment of the complications. The long term complications of these patients are not studied as the duration of the study was short and it requires further studies regarding the long term prognosis of these patients