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Yoon S, Kondakala S, Foley SL, Moon MS, Huang MCJ, Periz G, Zang J, Katz LM, Kim SJ, Kweon O. Detection of anaerobic and aerobic bacteria from commercial tattoo and permanent makeup inks. Appl Environ Microbiol 2024:e0027624. [PMID: 38953654 DOI: 10.1128/aem.00276-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/30/2024] [Indexed: 07/04/2024] Open
Abstract
Tattooing and use of permanent makeup (PMU) have dramatically increased over the last decade, with a concomitant increase in ink-related infections. Studies have shown evidence that commercial tattoo and PMU inks are frequently contaminated with pathogenic microorganisms. Considering that tattoo inks are placed into the dermal layer of the skin where anaerobic bacteria can thrive and cause infections in low-oxygen environments, the prevalence of anaerobic and aerobic bacteria should be assessed in tattoo and PMU inks. In this study, we tested 75 tattoo and PMU inks using the analytical methods described in the FDA Bacteriological Analytical Manual Chapter 23 for the detection of both aerobic and anaerobic bacterial contamination, followed by 16S rRNA gene sequencing for microbial identification. Of 75 ink samples, we found 26 contaminated samples with 34 bacterial isolates taxonomically classified into 14 genera and 22 species. Among the 34 bacterial isolates, 19 were identified as possibly pathogenic bacterial strains. Two species, namely Cutibacterium acnes (four strains) and Staphylococcus epidermidis (two strains) were isolated under anaerobic conditions. Two possibly pathogenic bacterial strains, Staphylococcus saprophyticus and C. acnes, were isolated together from the same ink samples (n = 2), indicating that tattoo and PMU inks can contain both aerobic (S. saprophyticus) and anaerobic bacteria (C. acnes). No significant association was found between sterility claims on the ink label and the absence of bacterial contamination. The results indicate that tattoo and PMU inks can also contain anaerobic bacteria. IMPORTANCE The rising popularity of tattooing and permanent makeup (PMU) has led to increased reports of ink-related infections. This study is the first to investigate the presence of both aerobic and anaerobic bacteria in commercial tattoo and PMU inks under aerobic and anaerobic conditions. Our findings reveal that unopened and sealed tattoo inks can harbor anaerobic bacteria, known to thrive in low-oxygen environments, such as the dermal layer of the skin, alongside aerobic bacteria. This suggests that contaminated tattoo inks could be a source of infection from both types of bacteria. The results emphasize the importance of monitoring these products for both aerobic and anaerobic bacteria, including possibly pathogenic microorganisms.
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Affiliation(s)
- Sunghyun Yoon
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Sandeep Kondakala
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Steven L Foley
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Mi Sun Moon
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Mei-Chiung Jo Huang
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Goran Periz
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Janet Zang
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Linda M Katz
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Seong-Jae Kim
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Ohgew Kweon
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
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Chalarca-Cañas D, Caviedes-Cleves MA, Correa-Londoño LA, Ospina-Gómez JP, Velásquez-Lopera MM. Tattoos: risks and complications, clinical and histopathological approach. An Bras Dermatol 2024; 99:491-502. [PMID: 38521707 PMCID: PMC11221160 DOI: 10.1016/j.abd.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/16/2023] [Accepted: 07/23/2023] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Skin modification through tattoos is as old as humanity itself. However, this trend is on the rise, and with the use of different types of pigments and application practices, both cutaneous and systemic complications can arise. Adverse reactions can be grouped into five classes: inflammatory, infectious, neoplastic, aesthetic, and miscellaneous. On histopathology, inflammatory reactions can exhibit a lichenoid pattern or present as spongiotic dermatitis, granulomatous reactions, pseudolymphoma, pseudoepitheliomatous hyperplasia, or scleroderma/morphea-like changes. This article reviews tattoo complications, including their clinical and histopathological characteristics. METHODS An open search was conducted on PubMed using the terms "tattoo", "complications", and "skin". No limits were set for period, language, or publication type of the articles. RESULTS Reactions to tattoos are reported in up to 67% of people who get tattooed, with papulonodular and granulomatous reactions being the most common. Some neoplastic complications have been described, but their causality is still debated. Any pigment can cause adverse reactions, although red ink is more frequently associated with them. Patients with pre-existing dermatoses may experience exacerbation or complications of their diseases when getting tattoos; therefore, this procedure is not recommended for this patient group. CONCLUSIONS Dermatological consultation is recommended before getting a tattoo, as well as a histopathological examination in case of complications. In patients who develop cutaneous inflammatory reactions following tattooing, additional studies are recommended to investigate systemic diseases such as sarcoidosis, pyoderma gangrenosum, atopic dermatitis, and neoplasms. It is important for physicians to be trained in providing appropriate care in case of complications.
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Affiliation(s)
- David Chalarca-Cañas
- Department of Dermatology, School of Medicine, University of Antioquia, Medellín, Colombia.
| | | | - Luis A Correa-Londoño
- Department of Dermatology, School of Medicine, University of Antioquia, Medellín, Colombia
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Bălăceanu-Gurău B, Apostol E, Caraivan M, Ion A, Tatar R, Mihai MM, Popa LG, Gurău CD, Orzan OA. Cutaneous Adverse Reactions Associated with Tattoos and Permanent Makeup Pigments. J Clin Med 2024; 13:503. [PMID: 38256637 PMCID: PMC10816451 DOI: 10.3390/jcm13020503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Tattooing is the procedure of implanting permanent pigment granules and additives into the dermal layer of the skin, serving various purposes such as decoration, medical identification, or accidental markings. There has been a significant rise in the popularity of decorative tattooing as a form of body art among both teenagers and young adults. Thus, the incidence of tattoos is increasing, with expanding applications such as permanent makeup, scar camouflage, nipple-areola, lips, and eyebrows tattooing, and utilization in oncological radiotherapy such as colon marking. However, there have been reported a broad range of adverse reactions linked to tattooing, encompassing allergic reactions, superficial and deep cutaneous infections, autoimmune disorders induced by the Koebner phenomenon, cutaneous tumors, and others. These reactions exhibit different onset times for symptoms, ranging from immediate manifestations after tattoo application to symptoms emerging several years later. Given the limited information on a tattoo's side effects, this review aims to elucidate the clinical spectrum of cutaneous complications of tattoos in different patients. The analysis will investigate both allergic and nonallergic clinical presentations of tattoo-related side effects, microscopic findings from skin biopsies, and therapeutic outcomes. This exploration is essential to improve our understanding of tattoo-related cutaneous complications and associated differential diagnoses and highlight the significance of patient awareness regarding potential risks before getting a tattoo.
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Affiliation(s)
- Beatrice Bălăceanu-Gurău
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Eliza Apostol
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | | | - Ana Ion
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, 010621 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Cristian-Dorin Gurău
- Orthopedics and Traumatology Clinic, Clinical Emergency Hospital, 014451 Bucharest, Romania;
| | - Olguța Anca Orzan
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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Moreno-Casas G, Pereira-González A, Rodríguez-Nevado I, Rubio-Fernández A, Chaves-Álvarez A. Granulomatous tattoo reaction treated with topical allopurinol. Clin Exp Dermatol 2023; 48:926-928. [PMID: 37094257 DOI: 10.1093/ced/llad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
Granulomatous reactions to tattoo ink have been frequently associated with exogenous pigment, although sometimes they are the manifestation of a cutaneous or an underlying systemic sarcoidosis. We report a case of a patient with a granulomatous reaction to a black tattoo pigment treated with 3% topical allopurinol for 3 months. We observed complete resolution without any side-effects. Examination and follow-up ruled out sarcoidosis. Oral allopurinol has been proven to be effective for the management of granulomatous reactions to tattoos. Based on the significant improvement we have described in our patient, we recommend new studies to reveal all the potential benefits of the topical use of allopurinol for the treatment of granulomatous reactions to tattoo ink.
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Cosio T, Coniglione F, Flaminio V, Gaziano R, Coletta D, Petruccelli R, Dika E, Bianchi L, Campione E. Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature. Int J Mol Sci 2023; 24:ijms24054580. [PMID: 36902013 PMCID: PMC10003408 DOI: 10.3390/ijms24054580] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Immunotherapy in oncology is replacing traditional therapies due to it specific action and limited side effects. Despite the high efficacy of immunotherapy, side effects such as bacterial infection have been reported. Bacterial skin and soft tissue infections represent one of the most important differential diagnoses in patients presenting with reddened and swollen skin and soft tissue. Among these infections, cellulitis (phlegmon) and abscesses are the most frequent. In most cases, these infections occur locally with possible contiguous spread, or as a multifocal manifestation, especially in immunocompromised patients. Herein, we report a case of pyodermitis in an immunocompromised district in a patient treated with nivolumab for non-small cell lung cancer. A 64-year-old, smoker male patient showed cutaneous lesions at a different evolution level in the left arm, all in a tattooed area, with one phlegmon and two ulcerated lesions. Microbiological cultures and gram staining revealed an infection caused by a methicillin-susceptible but erythromycin-resistant (ER-R), clindamycin-resistant (CL-R), and gentamicin-resistant (GE-R) Staphylococcus aureus strain. Despite immunotherapy becoming a milestone in oncologic treatment, more than the spectrum of immune-mediated toxicities of these agents needs to be investigated. This report highlights the importance of considering lifestyle and cutaneous background before starting immunotherapy for cancer treatment, with an emphasis on pharmacogenomics and the possibility of modified skin microbiota predisposing to cutaneous infections in patients treated with PD-1 inhibitors.
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Affiliation(s)
- Terenzio Cosio
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Filadelfo Coniglione
- Department of Surgical Sciences, University Nostra Signora del Buon Consiglio, 1000 Tirana, Albania
| | - Valeria Flaminio
- Medical Oncology Unit, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Roberta Gaziano
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Deborah Coletta
- Medical Oncology Unit, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Rosalba Petruccelli
- Laboratory of Microbiology, Microbiology and Virology Lab, Tor Vergata University Hospital, V. le Oxford, 81, 00133 Rome, Italy
| | - Emi Dika
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Unit of Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Elena Campione
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
- Correspondence:
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Bourgeois P, Roman MM, Schweicher J, Lavoisier P, Maquet P, Karler C, Lizewski M, Fouarge A, Cuylits N, del Marmol V, Leduc O. Lymphatic Alterations Under Tattoos: Preliminary Reports of One Observational Study. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2023; 16:257-265. [PMID: 36733347 PMCID: PMC9888301 DOI: 10.2147/ccid.s393038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 01/28/2023]
Abstract
Background The number of people within the European population having at least one tattoo has increased notably and with it the number of tattoo-associated clinical complications. The injected inks are known to be removed by the lymphatic vessels and can be found in the draining lymph nodes. Aim of the Study To report our observations on the lymphatic drainages seen under tattoos using near infrared fluorescence imaging of these lymphatic vessels after the injection of indocyanine green. Material and Methods Indocyanine green was injected intradermally at the basis of the 20 tattooed area(s) in 19 subjects (nine women and ten men; mean age = 28.6). Ten subjects had only black tattoos (six upper limbs and four lower limbs), five (two upper limbs and three lower limbs) black and white tattoos and five multi-colored tattooed limbs (four lower limbs and one upper limb). Results The imaging exams revealed alterations in eight individuals, seven of whom had tattoos on their lower limbs. Furthermore, the imaging results showed that the abnormalities might be related to the tattooed limb, the tattoo extent and colour. Conclusion Alterations of the cutaneous lymphatic channels are frequently observed under tattooed territories. Their causal factors should be more precisely studied in future works and these lymphatic alterations should be considered in tattooed patients when using similar imaging techniques for therapeutic and surgical assessments.
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Affiliation(s)
- Pierre Bourgeois
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium,Services of Nuclear Medicine, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Multi-Disciplinary Clinic of Lymphology, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium,Service of Vascular Surgery, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Correspondence: Pierre Bourgeois, Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, 808, route de Lennik, Brussels, 1070, Belgium, Tel +32495201906, Email
| | - Mirela Mariana Roman
- Department of Mammo-Pelvic Surgery, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Justine Schweicher
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Pauline Lavoisier
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Philippe Maquet
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Clarence Karler
- Department of Anesthesia-Algologia, Hospital Moliere, Université Libre de Bruxelles, Brussels, Belgium
| | - Mateusz Lizewski
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Alessandro Fouarge
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Cuylits
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Véronique del Marmol
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Leduc
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
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7
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Hernandez L, Mohsin N, Frech FS, Dreyfuss I, Vander Does A, Nouri K. Laser tattoo removal: laser principles and an updated guide for clinicians. Lasers Med Sci 2022; 37:2581-2587. [DOI: 10.1007/s10103-022-03576-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022]
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8
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Laske J, Maschke J, Bauer A, Beissert S, Aschoff R. Operative Treatment of Severe Allergic Reactions to Red Tattoo Dye: Presentation and Comparison of Possible Surgical Procedures in Seven Patients. J Cutan Aesthet Surg 2022; 15:24-32. [PMID: 35655643 PMCID: PMC9153303 DOI: 10.4103/jcas.jcas_202_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Context The treatment of allergic reactions to red tattoo dye is challenging in most cases, as local therapy often does not offer long-term improvement and laser therapy is considered relatively contraindicated by many authors owing to the risk of generalized side effects. Therefore, surgical removal of these tattoos is favored; shave excision is the method of choice, particularly for the removal of the entire dye. Aims The aim of this article was to retrospectively analyze the best post-operative outcome after surgical removal of allergic tattoo reactions using different excision techniques. Materials and Methods We compared the different surgical procedures performed on seven patients with single and multiple allergic tattoo reactions treated between 2013 and 2018. Results The best aesthetic results were achieved by superficial ablation of the inflammatory reaction, partially leaving tattoo remains in the skin. Conclusion Based on our experience with this small number of patients, a superficial removal of the tattoo without complete removal of the dye is, in most cases, sufficient to achieve healing. The remaining dye residues seem to be better tolerated by the immune system afterwards. Furthermore, the tattoo is often preserved in large parts.
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Affiliation(s)
- Joerg Laske
- Department of Dermatology, University Hospital – Dresden, Dresden, Germany
| | | | - Andrea Bauer
- Department of Dermatology, University Hospital – Dresden, Dresden, Germany
| | - Stefan Beissert
- Department of Dermatology, University Hospital – Dresden, Dresden, Germany
| | - Roland Aschoff
- Department of Dermatology, University Hospital – Dresden, Dresden, Germany
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9
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Cohen PR. Tattoo-Associated Viral Infections: A Review. Clin Cosmet Investig Dermatol 2021; 14:1529-1540. [PMID: 34720594 PMCID: PMC8549973 DOI: 10.2147/ccid.s284796] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022]
Abstract
Tattoos, a decorative form of body art, are produced by inoculating pigment into the dermis. Tattoo-associated viral infections can be cutaneous and localized to the tattoo ink; however, viral pathogens acquired during inoculation can cause systemic disease. A comprehensive review of the literature only reveals a limited number of published reports regarding patients with tattoo-associated cutaneous viral lesions. Cutaneous viral pathogens causing lesions to occur on a tattoo include herpes simplex virus (HSV), human papillomavirus (HPV), molluscum contagiosum, rubella, and vaccinia. HPV lesions (45 patients) and molluscum contagiosum (14 patients) are the most frequently reported tattoo-associated viral lesions; nearly all the patients were immunocompetent. HPV lesions included verruca vulgaris (29 patients), verruca plana (14 patients) and human immunodeficiency virus (HIV)-associated acquired epidermodysplasia verruciformis (two men). Hypotheses for tattoo-associated HPV lesions and molluscum contagiosum include a black ink-induced cutaneous immunocompromised district since the viral lesions all occurred in black or dark ink and the use of virus-contaminated instruments, pigment, or both during tattoo inoculation. Other sources of HPV include viral spread from a wart that is present but not associated with the tattoo site or virus transmission from the tattooist resulting from contact with a wart on an ungloved hand or HPV-containing saliva used to thin the pigment. Herpes compunctorum (three patients), vaccinia (two patients), and rubella (one patient) were less commonly reported. Blood borne viral pathogens associated with systemic manifestations – such as hepatitis B, hepatitis C and HIV – have also been acquired during tattoo inoculation; however, health care interventions have been adopted to attempt prevention of viral agent transmission during tattoo acquisition.
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Affiliation(s)
- Philip R Cohen
- Department of Dermatology, University of California, Davis Medical Center, Sacramento, CA, USA.,Department of Dermatology, Touro University California College of Osteopathic Medicine, Vallejo, CA, USA
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10
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Portilla Maya N, Kempf W, Perez Muñoz N, Rodríguez-Martínez P, Posada R, Fernández-Figueras MT. Histopathologic Spectrum of Findings Associated With Tattoos: Multicenter Study Series of 230 Cases. Am J Dermatopathol 2021; 43:543-553. [PMID: 34276026 DOI: 10.1097/dad.0000000000001695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE Reactions to tattoo may simulate common dermatosis or skin neoplasms. Histopathology allows diagnosis and helps determining the level and degree of inflammation associated, consequently orientating treatment. OBJECTIVE To describe the histological features found in biopsies of cutaneous reactions to tattoo. DESIGN This study was designed as a multicenter case series. SETTING All consecutive histopathological samples of tattoos referred from 1992 to 2019 to the Hospital General de Catalunya, Hospital Germans Trias i Pujol, and a private practice, all in Barcelona, Spain, and from the Kempf und Pfaltz Histologische Diagnostik in Zurich, Switzerland were retrieved from the files. PARTICIPANTS AND EXPOSURE The inclusion criteria were all cosmetic/permanent makeup, artistic/professional, and traumatic tattoos associated with either inflammatory reactions alone and/or with tumors and/or infections. Exclusion criteria were cases without any associated pathologic finding in the place of the ink, amalgam tattoos, and medical or temporary tattoos. MAIN OUTCOMES AND MEASURES In all patients, clinical features (age, sex, location, tattoo color, and presentation) were recorded. Histological features evaluated included ink color, associated tumors or infections, and inflammatory reaction pattern. Inflammation was graded in low to moderate or severe. RESULTS From 477 biopsies diagnosed as tattoos, 230 cases from 226 patients met the inclusion criteria. Samples corresponded to 107 male and 120 female subjects and 3 of unknown gender. Median age was 39 years (ranging from 9 to 84 years). Fifty-three samples were referred from centers in Spain and 177 from the center in Switzerland. The series was analyzed in 2 parts: tattoos associated only with inflammatory reactions (117/230) and tattoos associated with tumors or infections (113/230). The most common form of inflammatory pattern associated with tattoo was the fibrosing reaction (79/117, 68%), followed by granulomatous reaction (56/117, 48%), lichenoid reaction (33/117, 28%), epithelial hyperplasia (28/117, 24%), pseudolymphoma (27/117, 23%) and spongiotic reaction (27/117, 23%). Combined features of 2 or more types of inflammatory patterns were seen in 64% cases. CONCLUSIONS AND RELEVANCE Our series confirms that cutaneous reactions to tattoos are polymorphous. Inflammation tends to present with combined patterns. Infections are tending to decline, and pathologic findings are not specific to ink color or clinical features.
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Affiliation(s)
- Nataly Portilla Maya
- Dermatologist, Dermatology Department, Clínica Erasmo LTDA. Valledupar, Colombia
| | - Werner Kempf
- Dermatopathologist, Pathology Department, Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | - Noelia Perez Muñoz
- Pathologist, Pathology Department, Hospital Universitari General de Catalunya (HUGC), Sant- Cugat del Vallès, Spain; and
- Pulmonologist, Pathology Department, Hospital University German Trias I Pujol, Barcelona, Spain
| | | | - Rodolfo Posada
- Pathologist, Pathology Department, Hospital Universitari General de Catalunya (HUGC), Sant- Cugat del Vallès, Spain; and
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11
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Cunningham ET, Dunn JP, Smit DP, Zierhut M. Tattoo-Associated Uveitis. Ocul Immunol Inflamm 2021; 29:835-837. [PMID: 34955075 DOI: 10.1080/09273948.2021.2006517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.,The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA.,The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | - James P Dunn
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA
| | - Derrick P Smit
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Manfred Zierhut
- Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany
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12
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Karregat JJJP, Rustemeyer T, van der Bent SAS, Spiekstra SW, Thon M, Fernandez Rivas D, Gibbs S. Assessment of cytotoxicity and sensitization potential of intradermally injected tattoo inks in reconstructed human skin. Contact Dermatitis 2021; 85:324-339. [PMID: 34029376 PMCID: PMC8453820 DOI: 10.1111/cod.13908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/03/2021] [Accepted: 05/21/2021] [Indexed: 12/25/2022]
Abstract
Background The number of people within the European population having at least one tattoo has increased notably, and with it the number of tattoo‐associated clinical complications. Despite this, safety information and testing regarding tattoo inks remain limited. Objective To assess cytotoxicity and sensitization potential of 16 tattoo inks after intradermal injection into reconstructed human skin (RHS). Methods Commercially available tattoo inks were injected intradermally into RHS (reconstructed epidermis on a fibroblast‐populated collagen hydrogel) using a permanent makeup device. RHS biopsies, tissue sections, and culture medium were assessed for cytotoxicity (thiazolyl blue tetrazolium bromide assay [MTT assay]), detrimental histological changes (haematoxylin and eosin staining), and the presence of inflammatory and sensitization cytokines (interleukin [IL]‐1α, IL‐8, IL‐18; enzyme‐linked immunosorbent assay). Results Varying degrees of reduced metabolic activity and histopathological cytotoxic effects were observed in RHS after ink injection. Five inks showed significantly reduced metabolic activity and enhanced sensitization potential compared with negative controls. Discussion Using the RHS model system, four tattoo inks were identified as highly cytotoxic and classified as potential sensitizers, suggesting that allergic contact dermatitis could emerge in individuals carrying these inks. These results indicate that an RHS‐based assessment of cytotoxicity and sensitization potential by intradermal tattoo ink injection is a useful analytical tool to determine ink‐induced deleterious effects.
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Affiliation(s)
- Joey J J P Karregat
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Sander W Spiekstra
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Thon
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David Fernandez Rivas
- Mesoscale Chemical Systems Group, MESA+ Institute and Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Susan Gibbs
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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13
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Tomita S, Mori K, Yamazaki H. A Survey on the Safety of and Patient Satisfaction After Nipple-Areola Tattooing. Aesthetic Plast Surg 2021; 45:968-974. [PMID: 33112992 DOI: 10.1007/s00266-020-02018-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nipple-areolar tattooing is well accepted as part of breast reconstruction, but the clinical data on its safety and patient satisfaction after the procedure are insufficient. We aimed to evaluate the complications of and patient satisfaction after nipple-areola tattooing in Japanese post-mastectomy breast reconstruction patients. METHODS Patients who visited our center after undergoing nipple-areola tattooing from January 2017 to March 2020 were given an unmarked questionnaire with questions about complications related to their nipple-areola tattoo. Patients' registered their subjective evaluation responses regarding nipple-areola appearance using visual analog scale and that regarding overall satisfaction using 5-point Likert scale and free-text responses. Patients who were followed up within 6 months after tattooing or those with incomplete data were excluded. RESULTS Sixty-two patients (average age: 49.7 ± 9.8 years), with an average post-tattooing period of 21.2 ± 10.5 months, were included. No patient had infections or allergic reactions. The average VAS score for nipple-areola appearance was high (8.5), and 59 patients (95.3%) answered that they were satisfied. In the free-text patient responses, 25 patients answered that they now felt comfortable going to the hot spring or taking a bath with their children, and 19 patients reported improved mental health after the procedure. CONCLUSION Post-breast reconstruction nipple-areola tattooing with sterilized inorganic pigments could achieve high esthetics and patient satisfaction, without serious complications. It is recommended for Japanese individuals with a culture of visiting hot springs and public baths. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each submission to which evidence-based medicine rankings are applicable. This excludes review articles, book reviews, and manuscripts that concern basic science, animal studies, cadaver studies, and experimental studies. For a full description of these evidence-based medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266 .
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Affiliation(s)
- Shoichi Tomita
- Department of Plastic and Reconstructive Surgery, Tokyo Shinjuku Medical Center, Japan Community Health Care Organization, Tokyo, Japan.
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Serrano-Serra JP, Montero-Vilchez T, Buendia-Eisman A, Arias-Santiago S. Epidermal Barrier Function and Skin Homeostasis in Skin with Permanent and Adhesive Tattoos: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10040888. [PMID: 33671713 PMCID: PMC7926473 DOI: 10.3390/jcm10040888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022] Open
Abstract
Tattoos are a current trend, but their impact on skin homeostasis and epidermal barrier function is not well known. So, the aims of this study are (1) to investigate epidermal barrier function and skin homeostasis in skin with permanent tattoos, adhesive temporary tattoos and non-tattooed skin, and (2) to analyze the effect of petrolatum on skin with permanent and adhesive tattoos. In total, 67 tattoos were enrolled (34 permanent tattoos and 33 adhesive tattoos). Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), erythema and total antioxidant capacity (TAC) were measured in skin with permanent tattoos, adhesive tattoos and non-tattooed skin before and after petrolatum application. The temperature was lower (30.47 °C vs. 31.01 °C; p = 0.001) on skin with permanent tattoos than non-tattooed skin, while SCH (48.24 Arbitrary Units (AU) vs. 44.15 AU; p = 0.008) was higher. Skin with adhesive tattoos showed lower temperature, SCH (21.19 AU vs. 41.31 AU; p < 0.001) and TAC (1.27 microcoulombs (uC) vs. 3.48 uC; p < 0.001), and higher TEWL (8.65 g/h/m2 vs. 6.99 g/h/m2; p = 0.003), than non-tattooed skin. After petrolatum application, the temperature decreased on skin with permanent tattoos, and TEWL and SCH decreased on skin with adhesive tattoos. Adhesive tattoos may affect skin barrier function, while permanent tattoos may have a lower impact. Tattooed and non-tattooed skin responds in different ways to moisturizers.
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Affiliation(s)
- Jose-Pablo Serrano-Serra
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
| | - Trinidad Montero-Vilchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
- Correspondence: or ; Tel.: +34-958023259
| | - Agustin Buendia-Eisman
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
| | - Salvador Arias-Santiago
- Dermatology Department, Faculty of Medicine, University of Granada, 18012 Granada, Spain or (J.-P.S.-S.); (A.B.-E.); (S.A.-S.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain
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15
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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; 48:870-876. [PMID: 33527478 DOI: 10.1111/cup.13973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/05/2021] [Accepted: 01/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tattooing has been around for many years and is becoming an increasingly common fashion trend. As there are often few regulatory laws regarding the practice, an increase in the incidence of cutaneous reactions to tattoo inks is noted. These include allergic reactions, granulomatous dermatitis, infections, lichenoid dermatoses, and sometimes malignancy. The present study examines the histopathological changes seen in patients with cutaneous reactions to tattoo ink. METHOD A prospective observational study was conducted over 18 months in the dermatology clinic of a tertiary care center in western India. The study population included 22 patients with cutaneous reactions over the tattoos. Punch biopsy specimens were sent to study the pattern of histopathological response. RESULTS All 22 patients studied were between the ages of 17 and 35 years. The mean duration of development of reaction was 8.1 months. Most of the reactions were seen in black ink tattoos performed by amateurs. Perivascular and spongiotic dermatitis suggestive of allergic response was the most common feature on histopathology. Granulomatous response and lichenoid response were seen in five and three biopsies, respectively. CONCLUSION Legalization is needed for this practice to prevent tattoo reactions. Histopathological evaluation is important as tattoo reactions may be associated with skin infections and malignancies.
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Affiliation(s)
- Pooja Agarwal
- Department of Skin & VD, Smt SCL General Hospital, Ahmedabad, India
| | - Ashish Jagati
- Department of Skin & VD, Smt SCL General Hospital, Ahmedabad, India
| | - Rupal Mehta
- Department of Pathology, AMC MET Medical College, Ahmedabad, India
| | - Priyanka Vadher
- Department of Skin & VD, Smt SCL General Hospital, Ahmedabad, India
| | - Santosh Rathod
- Department of Skin & VD, Smt SCL General Hospital, Ahmedabad, India
| | - Priyanka Bodar
- Department of Skin & VD, Smt SCL General Hospital, Ahmedabad, India
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Osu T, Lechler-Lombardi J, Butler A, Newman M, Miłkowska K, Galbarczyk A, Richards G. Fluctuating asymmetry of finger lengths, digit ratio (2D:4D), and tattoos: A pre-registered replication and extension of Koziel et al. (2010). Early Hum Dev 2021; 152:105273. [PMID: 33227633 DOI: 10.1016/j.earlhumdev.2020.105273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tattoos bring risks yet no obvious evolutionary benefit. Koziel et al. (2010) reported increased fluctuating symmetry (a proxy for low developmental instability) in tattooed men, suggesting they could serve as fitness indicators. AIMS We replicate and extend the findings of Koziel et al. by examining fluctuating asymmetry of finger lengths and digit ratio (2D:4D) (a putative indicator of prenatal testosterone exposure) as predictors of adult tattoo prevalence. STUDY DESIGN We used an online survey with a correlational design. SUBJECTS Participants were recruited from the UK and Poland via university participant pools and social media. Data were available for presence/absence of tattoos and at least one predictor variable (composite Fluctuating Asymmetry [cFA], right-hand digit ratio [R2D:4D] and left-hand digit ratio [L2D:4D]) for n = 186 males and n = 997 females. OUTCOME MEASURES We firstly assessed presence/absence of tattoos; when at least one tattoo was present, we also examined overall number and highest visibility. RESULTS Greater cFA was associated with lower likelihood of having tattoos in males, though in females greater cFA was associated with higher numbers of tattoos. R2D:4D and L2D:4D correlated negatively with number of tattoos in males, and a positive correlation between L2D:4D and number of tattoos was observed in females. However, these latter findings did not remain significant after controlling for covariates. CONCLUSIONS Tattoos may act as fitness indicators in males, though this explanation appears not to extend to females. Prenatal testosterone may also play a role, though doubt is cast on this premise because 2D:4D effects did not remain statistically significant after controlling for covariates.
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Affiliation(s)
- Tinisha Osu
- School of Psychology, Faculty of Medical Sciences, Newcastle University, UK
| | | | - Amy Butler
- School of Psychology, Faculty of Medical Sciences, Newcastle University, UK
| | - Miles Newman
- School of Psychology, Faculty of Medical Sciences, Newcastle University, UK
| | - Karolina Miłkowska
- Department of Environmental Health, Faculty of Health Science, Jagiellonian University Medical College, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Science, Jagiellonian University Medical College, Poland
| | - Gareth Richards
- School of Psychology, Faculty of Medical Sciences, Newcastle University, UK.
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17
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Cutaneous non-allergic complications in tattoos: An overview of the literature. Presse Med 2020; 49:104049. [DOI: 10.1016/j.lpm.2020.104049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/28/2020] [Indexed: 01/09/2023] Open
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18
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Butterfield JL, Keyser SP, Dikshit KV, Kwon H, Koster MI, Bruns CJ. Solar Freckles: Long-Term Photochromic Tattoos for Intradermal Ultraviolet Radiometry. ACS NANO 2020; 14:13619-13628. [PMID: 32961057 DOI: 10.1021/acsnano.0c05723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
While tattooable nanotechnology for in-skin sensing and communication has been a popular concept in science fiction since the 1990s, the first tattooable intradermal nanosensors have only emerged in the past few years, and none have been demonstrated in human skin. We developed a photochromic tattoo that serves as an intradermal ultraviolet (UV) radiometer that provides naked-eye feedback about UV exposure in real time. These small tattoos, or "solar freckles", comprise dermally implanted colorimetric UV sensors in the form of nanoencapsulated leuco dyes that become more blue in color with increasing UV irradiance. We demonstrate the tattoos' functionality for both quantitative and naked-eye UV sensing in porcine skin ex vivo, as well as in human skin in vivo. Solar freckles offer an alternative and complementary approach to self-monitoring UV exposure for the sake of skin cancer prevention. Activated solar freckles provide a visual reminder to protect the skin, and their color disappears rapidly upon removal of UV exposure or application of topical sunscreen. The sensors are implanted in a minimally invasive procedure that lasts only a few seconds, yet remain functional for months to years. These semipermanent tattoos provide an early proof-of-concept for long-term intradermal sensing nanomaterials that provide users with biomedically relevant information in the form of an observable color change.
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Affiliation(s)
- Jesse L Butterfield
- Paul M. Rady Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado 80309, United States
| | - Sean P Keyser
- Paul M. Rady Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado 80309, United States
| | - Karan V Dikshit
- Materials Science & Engineering Program, University of Colorado-Boulder, Boulder, Colorado 80309, United States
| | - Hyejin Kwon
- Paul M. Rady Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado 80309, United States
| | - Maranke I Koster
- Department of Dermatology, University of Colorado-Denver, Anschutz Medical Campus, Denver, Colorado 80217, United States
| | - Carson J Bruns
- Paul M. Rady Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado 80309, United States
- ATLAS Institute, University of Colorado-Boulder, Boulder, Colorado 80309, United States
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19
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[Reluctance determinants of dermatologists about tattooing in patients with psoriasis. An international study]. Ann Dermatol Venereol 2020; 147:809-817. [PMID: 32896422 DOI: 10.1016/j.annder.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tattoos are an increasingly common phenomenon, with a prevalence of around 10-30 % of the population in Western countries. The "Tatou" project assessed the risks of tattooing for patients with psoriasis. The first part revealed strong opposition to tattoos in these patients on the part of dermatologists, despite fewer than a quarter of them having any personal experience of complications. The second part showed a very low rate (6.6 %) of local complications on tattoos in these patients as well as absence of severe complications. These observations led us to assess the reasons for reluctance about tattoos in the 468 dermatologists involved in the first part of the "Tatou" project. PATIENTS AND METHODS We conducted a cross-sectional international study in France, Finland and Italy to evaluate the experience and opinions of dermatologists regarding tattoos in psoriasis patients via an anonymous questionnaire. We then examined the stated reasons for opposition to tattoos in order to establish the profiles of "tattoo-sceptical" dermatologists with regard to 4 different situations: active psoriasis, quiescent psoriasis, treatment with topical steroids and biotherapies. RESULTS The opinion of dermatologists regarding tattoos was generally unfavourable (3.5±2.8/10), in particular, via multivariate analysis, among older dermatologists (P=0.01), dermatologists in private practice (P=0.04), and non-tattooed dermatologists (P<0.0001). In multivariate analysis, the main parameter affecting the position of practitioner with regard to tattoos was their personal opinion of tattoos (P<0.0001), regardless of disease activity or type of treatment. Italian, Finnish and female dermatologists exhibited greater reluctance but in a less consistent fashion. CONCLUSION This analysis suggests a lack of objectivity among dermatologists opposed to tattoos probably stemming more from a poor opinion of this practice than from any fear of complications in their psoriatic patients.
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20
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Galbarczyk A, Mijas M, Marcinkowska UM, Koziara K, Apanasewicz A, Ziomkiewicz A. Association between sexual orientations of individuals and perceptions of tattooed men. PSYCHOLOGY & SEXUALITY 2020. [DOI: 10.1080/19419899.2019.1679867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andrzej Galbarczyk
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Mijas
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of General Psychology, Institute of Psychology, Jagiellonian University, Krakow, Poland
- Department of General Psychology, Institute of Psychology, The Jesuit University Ignatianum in Krakow, Krakow, Poland
| | - Urszula M. Marcinkowska
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Anthropology, Yale University, New Haven, CT
| | - Karolina Koziara
- Department of General Psychology, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Anna Apanasewicz
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Anna Ziomkiewicz
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Gualdi G, Fabiano A, Moro R, Venturuzzo A, Monari P, Calzavara-Pinton P, Amerio P. Tattoo: Ancient art and current problems. J Cosmet Dermatol 2020; 20:602-604. [PMID: 32539240 DOI: 10.1111/jocd.13548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/08/2020] [Indexed: 01/16/2023]
Abstract
The popularity of tattoos in the today's society brings with it a significant increase of the incidence of associated cutaneous reactions. Among the several complications that may occur after a tattooing procedure, allergic and photo-allergic reactions, infections, and Koebner phenomenon are the most common ones observed. Most of these complications may be avoided by identifying, before tattooing, the presence of risk factors or comorbidities that may increase the risk of their onset.
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Affiliation(s)
- Giulio Gualdi
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Antonella Fabiano
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Ruggero Moro
- Doctorate School, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - Anna Venturuzzo
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Paola Monari
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Paolo Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
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Abstract
Picosecond laser technology was cleared by Food and Drug Administration in 2012 and enhanced our ability to clear both benign pigmentation and dermal ink through a photomechanical impact created in the tissue. This impact created is greater than comparative nanotechnology and can be accomplished with lower fluences and smaller pulse durations. The addition of a diffractive lens array (FOCUS lens) has created a new category in skin rejuvenation by stimulating elastin and collagen through photomechanical and photoacoustic effects and not only through traditional photothermal tissue effects.
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Affiliation(s)
- Raminder Saluja
- Saluja Cosmetic and Laser Center, Private Practice, 9615 Northcross Center Court, Suite B, Huntersville, NC 28078, USA
| | - Richard D Gentile
- Facial Plastic Surgery, Gentile Facial Plastic Surgery and Aesthetic Laser Center, 821 Kentwood Suite C, Youngstown, OH 44512, USA; Cleveland Clinic Akron General Hospital, Akron, OH, USA.
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Evaluation of phototoxicity of tattoo pigments using the 3 T3 neutral red uptake phototoxicity test and a 3D human reconstructed skin model. Toxicol In Vitro 2020; 65:104813. [DOI: 10.1016/j.tiv.2020.104813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 01/03/2023]
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24
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Grodner C, Beauchet A, Fougerousse A, Quiles‐Tsimaratos N, Perrot J, Barthelemy H, Parier J, Maccari F, Beneton N, Bouilly‐Auvray D, Ruer‐Mulard M, Boulard C, Jacobzone C, Thomas‐Beaulieu D, Pourchot D, Méry‐Bossard L, Chaby G, Girard C, Duval‐Modeste A, Vermersch‐Langlin A, Delaunay J, Marc S, Kemula M, Steff M, Bilan P, Liégeon A, Aubert H, Solyga B, Kluger N, Mahé E. Tattoo complications in treated and non‐treated psoriatic patients. J Eur Acad Dermatol Venereol 2020; 34:888-896. [DOI: 10.1111/jdv.15975] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 09/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- C. Grodner
- Dermatology Department Hôpital Victor Dupouy Argenteuil France
| | - A. Beauchet
- Public Health Department Hôpital Ambroise Paré Boulogne‐Billancourt France
| | - A.‐C. Fougerousse
- Dermatology Department Hôpital d'Instruction des Armées Bégin Saint Mandé France
| | | | - J.‐L. Perrot
- Dermatology Department CHU Saint‐Etienne Saint‐Etienne France
| | - H. Barthelemy
- Dermatology Department Centre Hospitalier d'Auxerre Auxerre France
| | - J. Parier
- Private Office La Varenne St Hilaire France
| | - F. Maccari
- Private Office La Varenne St Hilaire France
| | - N. Beneton
- Dermatology Department Centre Hospitalier du Mans Le Mans France
| | - D. Bouilly‐Auvray
- Dermatology Department Centre Hospitalier Universitaire de Dijon Dijon France
| | | | - C. Boulard
- Dermatology Department Hôpital Jacques Monod Le Havre Cedex France
| | - C. Jacobzone
- Dermatology Department Centre Hospitalier de Lorient Lorient France
| | - D. Thomas‐Beaulieu
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - D. Pourchot
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - L. Méry‐Bossard
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - G. Chaby
- Dermatology Department Hôpital Sud Amiens France
| | - C. Girard
- Dermatology Department Centre Hospitalier Universitaire de Montpellier Montpellier France
| | - A.‐B. Duval‐Modeste
- Dermatology Department Centre Hospitalier Universitaire Charles‐Nicolle Rouen France
| | | | | | - S. Marc
- Dermatology Department Hôpital François Quesnay Mantes La Jolie France
| | | | - M. Steff
- Dermatology Department Hôpital Intercommunal Robert‐Ballanger Aulnay‐sous‐Bois France
| | - P. Bilan
- Dermatology Department Hôpital Intercommunal Robert‐Ballanger Aulnay‐sous‐Bois France
| | - A.‐L. Liégeon
- Dermatology Department Hôpital de Valence Valence France
| | - H. Aubert
- Dermatology Department Centre Hospitalier Universitaire de Nantes Nantes France
| | - B. Solyga
- Private Office Fontenay‐sous‐Bois France
| | - N. Kluger
- Dermatology Department, Allergology, and Venereology University of Helsinki and Helsinki University Central Hospital Helsinki Finland
- Dermatology Department Tattoo Consultation Centre Hospitalier Universitaire Bichat‐Claude Bernard Assistance Publique‐Hôpitaux de Paris Paris France
| | - E. Mahé
- Dermatology Department Hôpital Victor Dupouy Argenteuil France
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Cherkaoui El Baraka F, Kluger N, Ollivier I, Bourgoin R, Grossin M, Zeboulon C, Phan C, Sin C, Mahé E. [Melanoma within tattoos: Two cases and a systematic literature review]. Ann Dermatol Venereol 2020; 147:285-292. [PMID: 31812363 DOI: 10.1016/j.annder.2019.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/13/2019] [Accepted: 10/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND There have been reports of malignant melanoma arising within tattoos. However, there is no clear relationship between tattoos and the development of cutaneous malignancies. We report two new cases of melanoma and provide a review of cases of melanoma reported in the medical literature. PATIENTS AND METHODS Case No. 1: a 61-year-old patient consulted following the appearance one year ago of a nodular lesion measuring 4.5×3cm on a blue and red tattoo on his back. Complete excision of the lesion with histological analysis revealed an ulcerated nodular melanoma with a Breslow depth of 7mm. No secondary sites were found. Case No. 2: a 39-year-old patient with a blue tattoo on his left arm consulted following the appearance of a pigmented lesion a few months earlier. Surgical excision was immediately performed, confirming the diagnosis of SSM, with a Breslow depth of 0.9mm. There was no sign of relapse 9 years later. DISCUSSION In our systematic review we noted 34 cases of melanoma occurring in tattoos. There was a high male prevalence (90.3%) and a relatively young mean age (45.9 years). Most tattoos were monochrome (71.0%). The average time between tattooing and onset of melanoma was 13.2 years. The most common sites of melanoma were the upper limbs (53.1%) and trunk (34.4%). Mean tumor size was 11.6mm. Histologic examination revealed 2 cases of melanoma in situ, and in 13 cases, the Breslow depth was 1mm or less. In 5 cases, macroscopic or microscopic lymph node metastasis (sentinel lymph node) was found at diagnosis, and in one case, in transit skin metastases were also observed at the time of diagnosis. We discuss the hypothetical pathogenic role of tattoos in melanoma.
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Affiliation(s)
- F Cherkaoui El Baraka
- Service de dermatologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - N Kluger
- Departments of dermatology, allergology and venereology, university of Helsinki, Helsinki university central hospital, Meilahdentie 2, PO Box 160, 00029 Helsinki, Finlande; Service de dermatologie, hôpitaux universitaires Paris-Nord-Val-de-Seine, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France
| | - I Ollivier
- Cabinet privé, 34, place des Lices, 35000 Rennes, France
| | - R Bourgoin
- Service d'anatomopathologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - M Grossin
- Service d'anatomopathologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - C Zeboulon
- Service de dermatologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - C Phan
- Service de dermatologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - C Sin
- Service de dermatologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - E Mahé
- Service de dermatologie, hôpital Victor Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.
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Kirchhof MG, Wong SM. Tattoos and human papilloma virus: A case report of tattoo-associated flat warts (verrucae planae). SAGE Open Med Case Rep 2019; 7:2050313X19857416. [PMID: 31258907 PMCID: PMC6585243 DOI: 10.1177/2050313x19857416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The prevalence of tattoos is increasing and as such every physician must be aware of the potential adverse events associated with tattooing. Here we present a 36-year-old man with a recent history of skin-coloured papules appearing suddenly in a 20-year-old tattoo on the right forearm. Biopsy and histologic examination confirmed a diagnosis of verrucae planae or flat warts. Tattoo-associated human papilloma virus infections develop clinical manifestations after long latency periods and are often difficult to treat. The risk of tattoo-related human papilloma virus infection should be discussed when considering acquiring a tattoo.
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Affiliation(s)
- Mark G Kirchhof
- Division of Dermatology, Faculty of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Se Mang Wong
- Department of Dermatology and Skin Science, The University of British Columbia, Vancouver, BC, Canada.,Division of Dermatology, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada
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27
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Nørreslet LB, Serup J, Kezic S, Engebretsen KA, Thyssen JP, Agner T, Clausen M. Tattoos and skin barrier function: Measurements of
TEWL
, stratum corneum conductance and capacitance,
pH
, and filaggrin. Skin Res Technol 2019; 25:382-388. [DOI: 10.1111/srt.12664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Line Brok Nørreslet
- Department of DermatologyBispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
| | - Jørgen Serup
- Department of DermatologyBispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
| | - Sanja Kezic
- Coronel Institute of Occupational HealthAmsterdam Public Health Research InstituteAmsterdam UMCUniversity of Amsterdam Amsterdam The Netherlands
| | | | - Jacob P. Thyssen
- Department of Dermatology and AllergyHerlev and Gentofte HospitalUniversity of Copenhagen Hellerup Denmark
| | - Tove Agner
- Department of DermatologyBispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
| | - Maja‐Lisa Clausen
- Department of DermatologyBispebjerg HospitalUniversity of Copenhagen Copenhagen Denmark
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28
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Chung J, Ince D, Ford BA, Wanat KA. Cutaneous Infections Due to Nontuberculosis Mycobacterium: Recognition and Management. Am J Clin Dermatol 2018; 19:867-878. [PMID: 30168084 DOI: 10.1007/s40257-018-0382-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Nontuberculous mycobacteria (NTM) are a diverse group of organisms that are ubiquitous in the environment, and the incidence of cutaneous infections due to NTM has been steadily increasing. Cutaneous infections due to NTM can be difficult to diagnose, due to their wide spectrum of clinical presentations and histopathological findings that are often nonspecific. A variety of modalities including tissue culture and polymerase chain reaction (PCR) assays may be necessary to identify the organism. Treatment can also be challenging, as it can depend on multiple factors, including the causative organism, the patient's immunological status, and the extent of disease involvement. In this review, we discuss the common presentations of cutaneous NTM infections, diagnostic tools, and treatment recommendations. A multi-disciplinary approach that involves good communication between the clinician, the histopathologist, the microbiologist, and infectious disease specialists can help lead to successful diagnosis and management.
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Affiliation(s)
- Jina Chung
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dilek Ince
- Division of Infectious Disease, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bradley A Ford
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Karolyn A Wanat
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
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29
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Tattoo-associated complications of metastatic melanoma treated with dabrafenib and trametinib. Melanoma Res 2018; 28:485-487. [DOI: 10.1097/cmr.0000000000000486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Grodner C, Kluger N, Fougerousse AC, Cinotti E, Lacarrubba F, Quiles-Tsimaratos N, Mahé E. Tattooing and psoriasis: dermatologists' knowledge, attitudes and practices. An international study. J Eur Acad Dermatol Venereol 2018; 33:e38-e40. [PMID: 29953677 DOI: 10.1111/jdv.15154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Grodner
- Dermatology Department, Victor Dupouy Hospital, Argenteuil, France
| | - N Kluger
- Dermatology Department, Allergology, and Venereology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,"Tattoo" Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A-C Fougerousse
- Dermatology Department, Hôpital d'Instruction des Armées Bégin, Saint Mandé, France
| | - E Cinotti
- Dermatology Department, Dipartimento di ScienzeMediche, Chirurgiche e Neuroscienze, A.O.U.S. Le Scotte - UniversitàdegliStudi di Siena, Siena, Italy
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | | | - E Mahé
- Dermatology Department, Victor Dupouy Hospital, Argenteuil, France
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31
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Wilson WT, O'Boyle M, Leach WJ. Unusual complication of a tattoo in an immunosuppressed patient. BMJ Case Rep 2018; 2018:bcr-2018-224968. [PMID: 29914878 DOI: 10.1136/bcr-2018-224968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Tattooing for decorative body art is becoming more popular and, as a result, so are tattoo-related complications. Patients are unlikely to discuss tattoos with medical professionals, even though these might be relevant. Long-term immunosuppressed patients are often young adults who may wish to consider tattooing. It is well recognised that immunosuppressed patients are at increased risk of infection including cutaneous mycobacterial infections. They therefore represent a group that is at a potentially higher risk of tattoo-related complications and warrant special consideration.We present the first documented case of inflammatory myopathy as a complication following tattooing in an immunosuppressed individual. This unusual case presented as distal thigh and medial knee pain and it was only after some time that a link to the tattoo was made. This serves as a reminder to consider tattoo-related complications in the differential diagnosis of unusual atraumatic musculoskeletal pain, especially in immunosuppressed individuals.
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Affiliation(s)
| | - Mannix O'Boyle
- Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - William J Leach
- Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK
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32
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Dieckmann R, Boone I, Brockmann SO, Hammerl JA, Kolb-Mäurer A, Goebeler M, Luch A, Al Dahouk S. The Risk of Bacterial Infection After Tattooing. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 113:665-671. [PMID: 27788747 DOI: 10.3238/arztebl.2016.0665] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/02/2015] [Accepted: 06/08/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tattooing is a globally growing trend. Overall prevalence among adults in industrialized countries is around 10-20%. Given the high and increasing numbers of tattooed people worldwide, medical and public health implications emerging from tattooing trends require greater attention not only by the public, but also by medical professionals and health policy makers. METHODS We performed a systematic review of the literature on tattooassociated bacterial infections and bacterial contamination of tattoo inks. Furthermore, we surveyed tattoo inks sampled during an international tattoo convention in Germany to study their microbial status. RESULTS Our systematic review identified 67 cases published between 1984 and 2015, mainly documenting serious bacterial infectious complications after intradermal deposition of tattoo inks. Both local skin infections (e.g. abscesses, necrotizing fasciitis) and systemic infections (e.g. endocarditis, septic shock) were reported. Published bacteriological surveys showed that opened as well as unopened tattoo ink bottles frequently contained clinically relevant levels of bacteria indicating that the manufactured tattoo product itself may be a source of infection. In our bacteriological survey, two of 39 colorants were contaminated with aerobic mesophilic bacteria. CONCLUSION Inappropriate hygiene measures in tattoo parlors and non-medical wound care are major risk factors for tattoo-related infections. In addition, facultative pathogenic bacterial species can be isolated from tattoo inks in use, which may pose a serious health risk.
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Affiliation(s)
- Ralf Dieckmann
- German Federal Institute for Risk Assessment (BfR), Department of Biological Safety, Berlin, Regional Public Health Office, Department for Infection Control, Reutlingen, University Hospital Würzburg, Department of Dermatology, Venereology and Allergology, Würzburg, German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Berlin, RWTH Aachen University Hospital, Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), Aachen
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33
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The need for an epidural “window of opportunity” in pregnant women with a lumbar tattoo. Int J Obstet Anesth 2018; 33:53-56. [DOI: 10.1016/j.ijoa.2017.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/26/2017] [Accepted: 09/15/2017] [Indexed: 11/21/2022]
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34
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Chatterjee K, Roy A, Ghosh R, Barua JK, Halder S, Banerjee G. The Bumpy Face of Che Guevara: An Interesting Case. Indian J Dermatol 2017; 62:675. [PMID: 29263554 PMCID: PMC5724329 DOI: 10.4103/ijd.ijd_1_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Placement of decorative tattoo on the skin may lead to various immunological, infective, and coincidental complications. Inoculation of human papillomavirus leading to development of verruca is an uncommon complication of tattoos. The present report highlights the development of verruca vulgaris, developing after 2 years of tattooing in a young male.
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Affiliation(s)
- Kingshuk Chatterjee
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Anupam Roy
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Romana Ghosh
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Jayanta Kumar Barua
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Saswati Halder
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Gautam Banerjee
- Department of Dermatology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
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35
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Sagoe D, Pallesen S, Andreassen CS. Prevalence and correlates of tattooing in Norway: A large-scale cross-sectional study. Scand J Psychol 2017; 58:562-570. [DOI: 10.1111/sjop.12399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/12/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science; University of Bergen; Bergen Norway
| | - Ståle Pallesen
- Department of Psychosocial Science; University of Bergen; Bergen Norway
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36
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Vascular access for hemodialysis and tattoos: a consideration to bear in mind. J Vasc Access 2017; 18:e73. [PMID: 28430310 DOI: 10.5301/jva.5000703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2017] [Indexed: 11/20/2022] Open
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37
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Unusual Eruption on the Arm. Am J Dermatopathol 2017; 39:e102-e103. [PMID: 28727602 DOI: 10.1097/dad.0000000000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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38
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Boulart L, Mimoun M, Noel W, Malca N, Chaouat M, Boccara D. Dealing with tattoos in plastic surgery. Complications and medical use. ANN CHIR PLAST ESTH 2017; 62:e23-e29. [DOI: 10.1016/j.anplas.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
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39
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Wu CH, Thong HY, Huang CC, Chen PH. Report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2016.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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40
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Galbarczyk A, Ziomkiewicz A. Tattooed men: Healthy bad boys and good-looking competitors. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.10.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Réactions dites « allergiques » aux tatouages : prise en charge et algorithme thérapeutique. Ann Dermatol Venereol 2016; 143:436-45. [DOI: 10.1016/j.annder.2016.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/02/2016] [Accepted: 03/17/2016] [Indexed: 11/19/2022]
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42
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Kluger N. Cutaneous and systemic complications associated with tattooing. Presse Med 2016; 45:567-76. [PMID: 27160631 DOI: 10.1016/j.lpm.2016.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/28/2016] [Accepted: 02/08/2016] [Indexed: 12/31/2022] Open
Abstract
Tattooing can result in a wide variety of complications, whose prevalence and incidence remain still unclear. Hypersensitivity reactions (or allergies) to tattoo pigments are currently the most common complication on a tattoo, however they are not predictable. Infections are nowadays directly related to the lack of asepsis and hygiene during the tattooing procedure or during the healing phase. Patients with a known cutaneous disease should be warned of a potential risk of localization of their disease to the tattoo. A skin eruption restricted to a tattoo may reveal sarcoidosis. Patients with chronic conditions and/or impaired immunity should discuss with their physician about the possibility and when to have a tattoo.
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Affiliation(s)
- Nicolas Kluger
- University of Helsinki, Helsinki University Central Hospital, dermatology, allergology and venereology, Meilahdentie 2, P.O. Box 160, FI-00029 HUS, Finland.
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Abstract
Tattoos are common and used extensively as either body art or cosmetic make-up; more rarely, they can be traumatic in nature. We have systemically analysed the literature for the patterns of red pigment tattoo reactions and their treatment options. Our search identified 18 articles; there was 1 non-randomised controlled trial, and the rest were small case studies. In total 139 patients were included within the studies. This review systematically analyses the different subsets of red tattoo reactions including lichenoid, dermatitis, granulomatous, pseudolymphomatous and miscellaneous reactions. The current evidence for the treatment for the above is presented. Dermatitis and lichenoid reactions appear to be the most common subtype of red pigment reactions with various treatment methods applied showing laser intervention to have some degree of success.
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44
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Islam PS, Chang C, Selmi C, Generali E, Huntley A, Teuber SS, Gershwin ME. Medical Complications of Tattoos: A Comprehensive Review. Clin Rev Allergy Immunol 2016; 50:273-86. [DOI: 10.1007/s12016-016-8532-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Almodovar-Real A, Sánchez-López J, Navarro-Triviño F, Fernández-Pugnaire MA. [Lichenoid reaction to red pigment in a tattoo]. Semergen 2016; 42:e115-e117. [PMID: 26858227 DOI: 10.1016/j.semerg.2015.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Affiliation(s)
- A Almodovar-Real
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España.
| | - J Sánchez-López
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - F Navarro-Triviño
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - M A Fernández-Pugnaire
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, España
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Laux P, Tralau T, Tentschert J, Blume A, Dahouk SA, Bäumler W, Bernstein E, Bocca B, Alimonti A, Colebrook H, de Cuyper C, Dähne L, Hauri U, Howard PC, Janssen P, Katz L, Klitzman B, Kluger N, Krutak L, Platzek T, Scott-Lang V, Serup J, Teubner W, Schreiver I, Wilkniß E, Luch A. A medical-toxicological view of tattooing. Lancet 2016. [PMID: 26211826 DOI: 10.1016/s0140-6736(15)60215-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Long perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.
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Affiliation(s)
- Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Tewes Tralau
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Jutta Tentschert
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Annegret Blume
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Sascha Al Dahouk
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Wolfgang Bäumler
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Regensburg, Germany
| | | | | | | | | | | | | | - Urs Hauri
- Kantonales Laboratorium Basel-Stadt, Basel, Switzerland
| | - Paul C Howard
- US Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | - Paul Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Linda Katz
- US Food and Drug Administration, College Park, MD, USA
| | - Bruce Klitzman
- Duke University Medical Center, Research Park, Durham, NC, USA
| | - Nicolas Kluger
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lars Krutak
- Smithsonian Institution, Washington, DC, USA
| | - Thomas Platzek
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | | | - Jørgen Serup
- Bispebjerg University Hospital, Department of Dermatology, The Tattoo Clinic, Copenhagen, Denmark
| | | | - Ines Schreiver
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Elena Wilkniß
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
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47
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Mushtaq J, Walker A, Hunter B. Under pressure: progressively enlarging facial mass following high-pressure paint injection injury. BMJ Case Rep 2016; 2016:bcr-2015-212817. [PMID: 26786528 DOI: 10.1136/bcr-2015-212817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
High-pressure paint injection injuries are relatively rare industrial accidents and almost exclusively occur on the non-dominant hand. A rarely documented complication of these injuries is the formation of a foreign body granuloma. We report a case of a 33-year-old man presenting with extensive facial scarring and progressive right paranasal swelling 7 years after a high-pressure paint injury. After imaging investigations, an excision of the mass and revision of scarring was performed. Access to the mass was gained indirectly through existing scarring over the nose to ensure an aesthetic result. Histological analysis revealed a florid granulomatous foreign body reaction to retained paint. To the best of our knowledge, this is the first reported case of a facial high-pressure paint injury with consequent formation of a foreign body granuloma.
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Affiliation(s)
| | | | - Ben Hunter
- St George's University of London, London, UK
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Kluger N. Self-reported tattoo reactions in a cohort of 448 French tattooists. Int J Dermatol 2015; 55:764-8. [PMID: 26499460 DOI: 10.1111/ijd.13030] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/13/2015] [Accepted: 03/04/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Self-reported complaints in people having tattoos, including swelling, itch, and photosensitivity, are frequent. Tattooists are usually heavily tattooed with multiple extended colored tattoos and constitute a specific population of interest. OBJECTIVES To assess the prevalence of cutaneous complications on tattoos among a cohort of French tattooists. METHODS An observational self-reported internet survey was performed among the tattooists of the French Tattoo Union in November 2013 to report on complaints about their tattoos. RESULTS Of the 448 respondents, 42.6% reported a "tattoo reaction" on a least one of their previous tattoos: transient itch (45.7%), wax-and-waning swelling (57%), and swelling after sun exposure (23%). A tattoo "allergy" on one color of the tattoo was found in 8%. Permanent itch, swelling, and cutaneous infection were rare. No skin cancer on tattoos was reported. The binary regression analysis revealed that the area of the tattooed body surface was the main driver of the risk of developing a tattoo reaction, mainly transient or permanent swelling triggered by sun exposure or not. The tattoo reaction, transient itch, and swelling on tattoos seemed to be associated with the sun protection habits of the tattooed individuals. CONCLUSION Professional tattooists have a high prevalence of minor complaints (transient itch and swelling) and photosensitivity on their tattoos such as in the general tattooed population.
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Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Abstract
Decorative tattoo is a popular practice that is generally safe when performed in the professional setting but can be associated with a variety of inflammatory, infectious, and neoplastic complications, risks that may be increased with current trends in home tattooing. Modern tattoo inks contain azo dyes and are often of unknown composition and not currently regulated for content or purity. Biopsy of most (if not all) tattoo reactions presenting to the dermatologist is recommended, given recent clusters of nontuberculous mycobacterial infections occurring within tattoo, as well as associations between tattoo reactions and systemic diseases such as sarcoidosis.
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Affiliation(s)
- Michi M Shinohara
- Divisions of Dermatology and Dermatopathology, University of Washington School of Medicine, Seattle, Washington.
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Bregnbak D, Johansen JD, Jellesen MS, Zachariae C, Menné T, Thyssen JP. Chromium allergy and dermatitis: prevalence and main findings. Contact Dermatitis 2015; 73:261-80. [DOI: 10.1111/cod.12436] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/12/2015] [Accepted: 05/12/2015] [Indexed: 12/14/2022]
Affiliation(s)
- David Bregnbak
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Hellerup 2900 Denmark
| | - Jeanne D. Johansen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Hellerup 2900 Denmark
| | - Morten S. Jellesen
- Materials and Surface Engineering, Department of Mechanical Engineering; Technical University of Denmark; DK-2800 Lyngby Denmark
| | - Claus Zachariae
- Department of Dermato-Allergology; Gentofte University Hospital; Hellerup 2900 Denmark
| | - Torkil Menné
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Hellerup 2900 Denmark
| | - Jacob P. Thyssen
- Department of Dermato-Allergology; National Allergy Research Centre, Copenhagen University Hospital Gentofte; Hellerup 2900 Denmark
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