Clinical cases of tattoo-associated dermatoses

Authors

DOI:

https://doi.org/10.34287/MMT.3(58).2023.8

Abstract

The aim of the work is to analyze clinical cases of tattoo-associated skin reactions as an example of the algorithm of differential diagnosis of dermatoses of this group.

Materials and methods. The personal observation of two clinical cases related to tattooing for aesthetic reasons and the appearance of a pathological reaction on the skin after the introduction of dyes is described. In addition to the visual assessment of the clinical picture, the final confirmation of the diagnosis was based on pathohistological examination.

Results. Variability of clinical manifestations associated with tattooing is presented. The first clinical case is represented by the symmetrical appearance of a rash in the form of small papules up to 0.3–0.4 cm in diameter with clear borders, pink in color, and rounded in shape in the area of the eyebrows after their tattooing. Morphologically, the effect of black pigment on the skin in this case is represented by non-specific granulomatous inflammation. The second clinical case is characterized by the appearance of a plaque with hyperkeratosis phenomena and subjective complaints of slight itching at the site of red tattoo dye injection. Pathohistological examination indicated dermatitis of the mixed group (lichenoid interface and granulomatous), which is most correspond to an allergic reaction to tattoo pigment.

Conclusions. The increase in the number of patients with tattoos requires a wider consideration of the complications that can be provoked by the artificial injection of dyes into the skin. Despite the advantage of allergic complications after tattooing, the risk of systemic diseases should raise the level of vigilance of practicing physicians regarding the timely diagnosis of sarcoidosis or aggressive neoplasia. The pathohistological examination is the “gold standard” for the final verification of complications after the artificial injection of pigment into the skin.

References

Tattoo statistics how many people have tattoos? [Internet]. History of Tattoos [cited 2023 Jun 25]. Available from: http://www.historyoftattoos.net/ tattoo-facts/tattoo-statistics

Agarwal P, Jagati A, Mehta R, Vadher P, Rathod S, Bodar P. Histopathological evaluation of cutaneous reactions to tattoos: Study at a tertiary care center. J Cutan Pathol. 2021;48(7):870-6. doi: 10.1111/cup.13973.

van der Bent S, Oyen E, Rustemeyer T, Jaspars L, Hoekzema R. Histopathology of Red Tattoo Reactions. Am J Dermatopathol. 2021;43(5):331-7. doi: 10.1097/DAD.0000000000001751.

Serup J, Hutton Carlsen K, Dommershausen N, Sepehri M, Hesse B, Seim C, et al. Identification of pigments related to allergic tattoo reactions in 104 human skin biopsies. Contact Dermatitis. 2020;82(2):73-82. doi: 10.1111/cod.13423.

Weiß KT, Schreiver I, Siewert K, Luch A, Haslböck B, Berneburg M, et al. Tattoos more than just colored skin? Searching for tattoo allergens. J Dtsch Dermatol Ges. 2021;19(5):657-69. doi: 10.1111/ddg.14436.

Ogura Y, Morimoto H, Ohtsuka M, Tokura Y. Paraphenylenediamine ingredient possibly contributes to granuloma formation in inflammatory tattoo. J Cutan Immunol Allergy. 2022;5:72-3. doi: 10.1002/cia2.12214.

Karbowska B, Rębiś T, Zembrzuska J, Nadolska K. Thallium in color tattoo inks: risk associated with tattooing. Med Pr. 2020;71(4):405-11. doi: 10.13075/mp.5893.00934.

Tammaro A, Magri F, Chello C, Sernicola A, Luzi F, De Marco G, et al. A peculiar adverse reaction to blue pigment tattoo. J Cosmet Dermatol. 2020;19(9):2401-2403. doi: 10.1111/jocd.13494.

van der Bent SAS, Berg T, Karst U, Sperling M, Rustemeyer T. Allergic reaction to a green tattoo with nickel as a possible allergen. Contact Dermatitis. 2019;81(1):64-6. doi: 10.1111/cod.13226.

Rahbarinejad Y, Guio-Aguilar P, Vu AN, Lo M, McTigue C, Nirenberg A, et al. Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review. J Clin Med. 2023 Mar 21;12(6):2424. doi: 10.3390/ jcm12062424.

Chen CA, Mikailov A, Faulkner-Jones B, Wu PA. Leukocytoclastic vasculitis sparing a tattoo with halo effect. JAAD Case Rep. 2015;1(5):269-71. doi: 10.1016/j.jdcr.2015.06.002.

Serup J. How to Diagnose and Classify Tattoo Complications in the Clinic: A System of Distinctive Patterns. Curr Probl Dermatol. 2017;52:58-73. doi: 10.1159/000450780.

Silvestre JF, González Villanueva I. Diagnostic Approach for Suspected Allergic Cutaneous Reaction to a Permanent Tattoo. J Investig Allergol Clin Immunol. 2019;29(6):405-13. doi: 10.18176/jiaci.0383.

Sepehri M, Hutton Carlsen K, Serup J. Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material. Dermatology. 2016;232(6):679-86. doi: 10.1159/000453315.

Rello J, Tejada S, Campogiani L, Adebanjo AG, Tammaro A. Systemic infections associated with tattoos or permanent makeup: A systematic review. Med Clin (Barc). 2022;158(4):159-66. English, Spanish. doi: 10.1016/j. medcli.2021.01.014.

Tampa M, Mitran MI, Mitran CI, Matei C, Amuzescu A, Buzatu AA, et al. Viral Infections Confined to Tattoos-A Narrative Review. Medicina (Kaunas). 2022;58(3):342. doi: 10.3390/medicina58030342.

Lehner K, Santarelli F, Vasold R, König B, Landthaler M, Bäumler W. Black tattoo inks are a source of problematic substances such as dibutyl phthalate. Contact Dermatitis. 2011;65(4):231-8. doi: 10.1111/j.16000536.2011.01947.x.

Hering H, Zoschke C, Kühn M, Gadicherla AK, Weindl G, Luch A, et al. TatS: a novel in vitro tattooed human skin model for improved pigment toxicology research. Arch Toxicol. 2020;94(7):2423-34. doi: 10.1007/ s00204-020-02825-z.

Leijs M, Schaefer H, Rübben A, Cacchi C, Rustemeyer T, van der Bent S. Cutaneous Malignancies in Tattoos, a Case Series of Six Patients. Curr Oncol. 2021;28(6):4721-37. doi: 10.3390/curroncol28060398.

Ricci F, Paradisi A, Maier SA, Kovacs M, Podda M, Peris K, et al. Melanoma and tattoos: a case report and review of the literature. Eur J Dermatol. 2018;28(1):50-5. doi: 10.1684/ejd.2017.3184.

Lerche CM, Heerfordt IM, Serup J, Poulsen T, Wulf HC. Red tattoos, ultraviolet radiation and skin cancer in mice. Exp Dermatol. 2017;26(11):1091-6. doi: 10.1111/exd.13383.

Sepehri M, Lerche CM, Hutton Carlsen K, Serup J. Search for Internal Cancers in Mice Tattooed with Inks of High Contents of Potential Carcinogens: A One-Year Autopsy Study of Red and Black Tattoo Inks Banned in the Market. Dermatology. 2017;233(1):94-9. doi: 10.1159/000468150.

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Published

2023-09-25

How to Cite

Makurina, H. I., Cherneda, L. O., & Dolia, O. S. (2023). Clinical cases of tattoo-associated dermatoses. Modern Medical Technology, (3), 53–57. https://doi.org/10.34287/MMT.3(58).2023.8

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Section

Clinical cases