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Verdaguer-Faja J, Mora-Fernandez V, Fabregat-Pratdepadua M, Jaka A. "A Strange Flower in the Garden": The Importance of the Dermatoscope in the Assessment of Tattoos. Dermatol Pract Concept 2024; 14:dpc.1401a11. [PMID: 38364428 PMCID: PMC10868892 DOI: 10.5826/dpc.1401a11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Júlia Verdaguer-Faja
- Dermatology and Venereology Department. Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Verónica Mora-Fernandez
- Dermatology and Venereology Department. Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Maria Fabregat-Pratdepadua
- Dermatology and Venereology Department. Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Ane Jaka
- Dermatology and Venereology Department. Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
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2
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Kinkar LI, Magboul MA, Alamri GE, Shaheen EA, Altalhi ER, Alharthi AM, Baabdullah AM. Knowledge and Attitude Towards Cutaneous Complications of Tattoos and Piercings Among the General Population in Saudi Arabia. Cureus 2023; 15:e49912. [PMID: 38174194 PMCID: PMC10763695 DOI: 10.7759/cureus.49912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Tattooing and piercing, which were uncommon in affluent countries, have recently spread throughout societies. Over the past two decades, young people have shown considerable excitement for the practice. This reported growth creates more difficulties because of the numerous operations performed without awareness of health and hygiene requirements. This study aims to assess the knowledge and attitudes of the general population toward the cutaneous complications of tattoos and piercings in Saudi Arabia. Methods This was a web-based descriptive cross-sectional study. An online questionnaire was developed by the study researchers, which included participants' demographic data, their knowledge of tattoos and piercings with associated health effects and possible infections, their attitude towards tattoos and piercings, and their practice and experienced complications regarding tattooing and body piercing. The final validated questionnaire was made publicly available via social media until no more new responses were obtained. Results Eight hundred and forty-eight individuals completed the study questionnaire. The ages of the participants varied from 18 to more than 55 years old, with a mean age of 25.2 ± 13.9 years, and (589 [69.5%]) were female. The most reported health effects and infections were bacterial infections in place of body modification (479 [56.5%]), purpura (380 [44.9%]), cutaneous abscesses (380 [44%]), melanoma (338 [39.9%]), hepatitis B virus (321 [37.9%]), HIV (311 [36.7%]), sepsis (306 [36.2%]), allergic contact dermatitis (296 [35%]), and hepatitis C virus (279 [33.1%]). In total, 336 (39.6%) had an overall good knowledge of tattooing and body piercing hazards, with higher knowledge among females with high education (p< 0.05). Conclusion This study revealed that one in three individuals knew about the health risks and infections associated with tattooing and body piercing. Higher awareness was found among females with high education levels. Of all the associated complications, procedure-related infections were the most common among participants.
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Affiliation(s)
- Lina I Kinkar
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Maan A Magboul
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ghadeer E Alamri
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Esraa A Shaheen
- Department of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Elaf R Altalhi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Ahmed M Baabdullah
- Department of Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Department of Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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3
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Monfrecola G, Fornaro L, Ascierto PA, Scarpato L, Anniciello AM, Fabbrocini G, Marasca C. Could wide tattoo delay the early diagnosis of cutaneous melanoma? J Eur Acad Dermatol Venereol 2023; 37:e1117-e1118. [PMID: 36912734 DOI: 10.1111/jdv.19037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Giuseppe Monfrecola
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luigi Fornaro
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paolo Antonio Ascierto
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Luigi Scarpato
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Anna Maria Anniciello
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
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Schubert S, Kluger N, Schreiver I. Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997-2022. Contact Dermatitis 2023; 88:331-350. [PMID: 36772861 DOI: 10.1111/cod.14291] [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: 09/05/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
We outline constituents of tattoo and permanent make-up ink with regard to inflammatory tattoo reactions and population-based confounders. The comprehensive review of patch-tested tattoo patients between 1997 and 2022 shows that tattoo allergy cannot be reliably diagnosed via patch testing with today's knowledge. Weak penetration and slow haptenization of pigments, unavailability of pigments as test allergens and a lack of knowledge concerning relevant epitopes hamper the diagnosis of tattoo allergy. Patch testing p-phenylenediamine and disperse (textile) dyes is not able to close this gap. Sensitization to metals was associated with all types of tattoo complications, although often not clinically relevant for the tattoo reaction. Binders and industrial biocides are frequently missing on ink declarations and should be patch tested. The pigment carbon black (C.I. 77266) is no skin sensitizer. Patch tests with culprit inks were usually positive with cheap ink products for non-professional use or with professionally used inks in patients with eczematous reactions characterized by papules and infiltration. Tape stripping before patch testing and patch test readings on Day 8 or 10 may improve the diagnostic quality. The meaningfulness of the categorical EU-wide ban of Pigment Green 7 and Pigment Blue 15:3 is not substantiated by the presented data.
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Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Nicolas Kluger
- Department of Dermatology, 'Tattoo' Consultation, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Dermatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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5
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Bazzacco G, Giulioni E, Marafioti I, Vezzoni R. My tattoo has come to life. Int J Dermatol 2022; 61:e498-e499. [PMID: 35503931 DOI: 10.1111/ijd.16237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Giulia Bazzacco
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Erika Giulioni
- Dermatology Clinic, Santa Maria degli Angeli Hospital, Pordenone, Friuli-Venezia Giulia, Italy
| | - Ilenia Marafioti
- Dermatology Clinic, Santa Maria degli Angeli Hospital, Pordenone, Friuli-Venezia Giulia, Italy
| | - Roberta Vezzoni
- Dermatology Clinic, Santa Maria degli Angeli Hospital, Pordenone, Friuli-Venezia Giulia, Italy
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Abstract
ABSTRACT Tattoos are characterized by the introduction of exogenous pigments into the dermis. Tattoos usually serve cosmetic purposes, although they may have other causes, such as traumatic pigment implants in accidents or medical-related tattoos in the context of radiotherapy. Dermatologic adverse reactions are relatively uncommon, and they include infections, immune-mediated reactions, cutaneous lesions secondary to the Koebner phenomenon, exacerbation of preexisting dermatosis, benign and malignant neoplasms, and a miscellaneous group of dermatologic conditions that may appear in a preexisting tattoo. The aim of this study is to review the types of histopathologic reactions that may appear in a preexisting permanent tattoo.
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DeBiasio C, Li HOY, Brandts-Longtin O, Kirchhof MG. European Tattoo Ingredient Ban - Implications for North America. J Am Acad Dermatol 2022; 87:933-934. [DOI: 10.1016/j.jaad.2022.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
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Famele M, Lavalle R, Leoni C, Majorani C, Ferranti C, Palleschi L, Fava L, Draisci R, D'Ilio S. Quantification of Preservatives in Tattoo And Pmu Inks in The Frame of The New Requirements Under Reach Regulation. Contact Dermatitis 2022; 87:233-240. [PMID: 35289945 DOI: 10.1111/cod.14105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND According to the REACH restriction, tattoo and permanent make-up (PMU) inks placed on the EU market after 4th January 2022 shall not contain methylisothiazolinone (MI), benzisothiazolinone (BIT), octylisothiazolinone (OIT) or other skin sensitisers in concentrations ≥10 mg/kg and phenoxyethanol (PE) or other eye irritants or damaging substances in concentrations ≥100 mg/kg. In addition, preservatives and other substances enlisted in Annex II to Cosmetic Product Regulation shall not be present in concentrations ≥0.5 mg/kg. OBJECTIVES Quantification of 14 preservatives in 99 tattoo and 39 PMU inks from the Italian market and comparison with concentration limits set by REACH restriction. MATERIALS AND METHODS Inks were analysed by applying validated analytical methods based on liquid-chromatography techniques. RESULTS About 24.0% and 1.5% of the overall samples contained BIT and OIT respectively in concentrations ≥10 mg/kg; PE was detected at concentrations ≥100 mg/kg in 15.2% of samples. Number of non-compliant tattoo inks (49.5%) would be significantly greater than PMU samples (17.9%). CONCLUSIONS About 40.6% of the samples would be non-compliant with the restriction for the presence of preservatives above the permitted level. Additional concentration limits will apply to skin sensitising preservatives for proper labelling of inks under CLP Regulation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Marco Famele
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Roberta Lavalle
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Claudia Leoni
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Costanza Majorani
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Carolina Ferranti
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Luca Palleschi
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Luca Fava
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Rosa Draisci
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
| | - Sonia D'Ilio
- National Centre for Chemicals, Cosmetics and Consumer Health Protection, Istituto Superiore di Sanità, viale Regina Elena n. 299, Rome, Italy
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Tampa M, Mitran MI, Mitran CI, Matei C, Amuzescu A, Buzatu AA, Georgescu SR. Viral Infections Confined to Tattoos—A Narrative Review. Medicina (B Aires) 2022; 58:medicina58030342. [PMID: 35334518 PMCID: PMC8955137 DOI: 10.3390/medicina58030342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 01/19/2023] Open
Abstract
Since ancient times, people have tattooed their skin for various reasons. In the past, tattoos were associated with low social status; nowadays, tattoos are very popular and are considered a form of art. However, tattoos are associated with various clinical problems, including immune reactions, inflammatory disorders, infections, and even skin cancer. Epidemiological and clinical data of infections on tattoos are scarce. Tattoo-related infections are mostly bacterial; only a few localized viral infections have been reported so far and are caused by molluscum contagiosum virus (MCV), human papillomavirus (HPV), and herpes simplex virus (HSV). In most cases, the lesions were strictly confined to the area of the tattoo. In this review, we have analysed reported cases of viral infections localized on tattoos and discussed the possible mechanisms involved in the occurrence of these infections.
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Affiliation(s)
- Mircea Tampa
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.T.); (C.M.); (S.R.G.)
- Department of Dermatology, ‘Victor Babes’ Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
| | - Madalina Irina Mitran
- Department of Microbiology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Microbiology, “Cantacuzino” National Medico-Military Institute for Research and Development, 011233 Bucharest, Romania
| | - Cristina Iulia Mitran
- Department of Microbiology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Microbiology, “Cantacuzino” National Medico-Military Institute for Research and Development, 011233 Bucharest, Romania
- Correspondence: (C.I.M.); (A.A.B.)
| | - Clara Matei
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.T.); (C.M.); (S.R.G.)
| | - Andreea Amuzescu
- Department of Dermatology, ‘Victor Babes’ Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
| | - Alina Andreea Buzatu
- Department of Communications and Public Relations, Faculty of Letters, University of Bucharest, 010017 Bucharest, Romania
- Correspondence: (C.I.M.); (A.A.B.)
| | - Simona Roxana Georgescu
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.T.); (C.M.); (S.R.G.)
- Department of Dermatology, ‘Victor Babes’ Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
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10
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Oppel E, Kapp F, Böhm AS, Pohl R, Thomas P, Summer B. Contact sensitization to iron - a potentially underestimated metal allergen and elicitor of complications in patients with metal implants. Contact Dermatitis 2022; 86:531-538. [PMID: 35172024 DOI: 10.1111/cod.14074] [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: 11/15/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about sensitization to iron (Fe) in private, working and medical settings, particulary implantology. OBJECTIVES To investigate sensitization to metals, particularly to Fe, both in pre-implant individuals with presumed metal allergy and in patients with suspected metal implant allergy. To further characterize Fe-sensitized individuals. METHODS Analysis of patch test reactions to an Fe (II)-sulfate-containing metal series in 183 consecutive patients (41 pre-implant, 142 metal implant-bearers). Test readings on D2, D3 and D6. Evaluation of questionnaire-aided history, of metal reactivity patterns, and demographics of Fe-reactors. RESULTS Metal reactivity in pre-implant/implant/total group was: to nickel 39%/30%/32%; to cobalt 17%/15%/15%; to chromium 7%/13%/11%. Co-sensitizations cobalt/nickel (19/58) and cobalt/chromium (11/21) were significant at P < .001; co-sensitizations Fe/Nickel (4/10) and chromium/knee arthroplasty (11/73) at P = .03. Ten of 183 (5.5%) reacted to Fe (2 of 41 pre-implant patients, 8 of 142 implant-bearers) with 10 only reacting on D6. Fe-reactivity was highest in complicated knee arthroplasty (7/73). Further peculiarities of Fe reactors included frequent isolated Fe reactivity (6/10), occupational metal exposure (7/10), previous (par)enteral Fe-substitution (6/10). CONCLUSIONS The 5.5% prevalence of Fe-reactions suggests a potentially underestimated role of this metal allergen in general and in implant-bearers. The latter also show a distinct metal sensitization pattern. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Eva Oppel
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Florian Kapp
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Ann-Sophie Böhm
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Ralf Pohl
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Peter Thomas
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Burkhard Summer
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
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Cohen PR, Crowley CS, Erickson CP, Calame A. Tinea and Tattoo: A Man Who Developed Tattoo-Associated Tinea Corporis and a Review of Dermatophyte and Systemic Fungal Infections Occurring Within a Tattoo. Cureus 2022; 14:e21210. [PMID: 35174019 PMCID: PMC8840820 DOI: 10.7759/cureus.21210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
Fungal infections may occur within tattoos. These include not only dermatophyte infections (tattoo-associated tinea) but also systemic mycoses (tattoo-associated systemic fungal infections). The PubMed search engine, accessing the MEDLINE database, was used to search for all papers with the terms: (1) tinea and tattoo, and (2) systemic fungal infection and tattoo. Tattoo-associated tinea corporis has been observed in 12 individuals with 13 tattoos; this includes the 18-year-old man who developed a dermatophyte infection, restricted to the black ink, less than one-month after tattoo inoculation on his left arm described in this report. Tattoo-associated tinea typically occurred on an extremity in the black ink. The diagnosis was established either by skin biopsy, fungal culture, and/or potassium hydroxide preparation. The cultured dermatophytes included Trichophyton rubrum, Epidermophyton floccosum, Microsporum canis, Microsporum gypseum, and Trichophyton tonsurans. Several sources for the tinea were documented: autoinfection (two patients), anthrophilic (tinea capitis from the patient’s son), and zoophilic (either the patient’s cat or dog). Three patients presented with tinea incognito resulting from prior corticosteroid treatment. Tinea appeared either early (within one month or less after inoculation during tattoo healing) in six patients or later (more than two months post-inoculation in a healed tattoo) in six patients. Injury to the skin from the tattoo needle, or use of non-sterile instruments, or contaminated ink, and/or contact with a human or animal dermatophyte source are possible causes of early tinea infection. Tattoo ink-related phenomenon (presence of nanoparticles, polycyclic aromatic hydrocarbons, and cytokine-enhancement) and/or the creation of an immunocompromised cutaneous district are potential causes of late tinea infection. Treatment with topical and/or oral antifungal agents provided complete resolution of the dermatophyte for all the patients with tattoo-associated tinea. Tattoo-associated systemic fungal infection has been reported in six patients: five men and one patient whose age, sex, immune status, and some tattoo features (duration, color, and treatment) were not reported. The onset of infection after tattoo inoculation was either within less than one month (two men), three months (two men), or 69 months (one man). The tattoo was dark (either black or blue) and often presented as papules (three men) or nodules (two men) that were either individual or multiple and intact or ulcerated. The lesion was asymptomatic (one man), non-tender (one man), or painful (one man). The systemic fungal organisms included Acremonium species, Aspergillus fumigatus, Purpureocillium lilacinum, Saksenaea vasiformis, and Sporothrix schenckii. Contaminated tattoo ink was a confirmed cause of the systemic fungal infection in one patient; other postulated sources included non-professional tattoo inoculation, infected tattooing tool and/or ink in an immunosuppression host, and contaminated ritual tattooing instruments and dye. Complete resolution of the tattoo-associated systemic fungal infection occurred following systemic antifungal drug therapy. In conclusion, several researchers favor that tattoo inoculation can be implicated as a causative factor in the development of tattoo-associated tinea; however, in some of the men, tattoo-associated systemic fungal infection may have merely been coincidental.
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12
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Sindoni A, Valeriani F, Gallè F, Liguori G, Romano Spica V, Vitali M, Protano C. Adverse effects related to tattoos in the community setting: a systematic review. J Epidemiol Community Health 2021; 75:1023-1028. [PMID: 34253557 DOI: 10.1136/jech-2021-216874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tattoos were historically associated with deviant behaviours or religious and other social purposes, but in the last decades, they have gained increasing popularity and have become a mainstream. The aim of this systematic review is to assess the literature evidence about decorative tattoos complications, considering both infective and non-infective risks. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following electronic bibliographic databases: PubMed, Scopus and Web of Science (science and social science citation index). RESULTS The literature search resulted in 6473 studies. A total of 207 full articles were considered potentially relevant and were reviewed independently by researchers. After full-text evaluation, 152 of 207 articles were excluded, as they did not meet selection criteria. The remaining 55 studies were included in the systematic review and their quality assessment was performed. Ten studies reported microbiological complications, 37 reported non-microbiological effects and eight reported either microbiological and non-microbiological complications. CONCLUSIONS Several well-known and uncommon risks are associated with tattooing and tattoo after-care. Public health authorities could take into account health education programmes for tattooists and customers in order to prevent health complications in people with tattoos. PROSPERO REGISTRATION NUMBER CRD42020177972.
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Affiliation(s)
- Alessandro Sindoni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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Ishii A, Watanabe S, Nishihara C, Kakiuchi M, Akaike Y, Itakura J, Uchino K, Manabe T, Notohara K. Previously unreported permanent tattoo-associated angiolymphoid hyperplasia with eosinophilia/epithelioid hemangioma. Pathol Int 2021; 71:219-221. [PMID: 33503288 DOI: 10.1111/pin.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Aya Ishii
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | | | - Chika Nishihara
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Minami Kakiuchi
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Yoko Akaike
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Junya Itakura
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Kaori Uchino
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | | | - Kenji Notohara
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
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Sławińska M, Rogowska P, Nowicki RJ, Sobjanek M. An unexpected cause of an itchy tattoo revealed in videodermoscopic examination. Clin Exp Dermatol 2020; 46:355-356. [PMID: 32658326 DOI: 10.1111/ced.14375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- M Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - P Rogowska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - R J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
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Schlott S, Karrer S, Terhorst-Molawi D, Dissemond J. Pyoderma gangrenosum as a late complication in tattoos: A case report series. Int Wound J 2020; 17:2031-2032. [PMID: 32662569 PMCID: PMC7948568 DOI: 10.1111/iwj.13453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Swantje Schlott
- Department for Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | - Sigrid Karrer
- Department for Dermatology, University of Regensburg, Regensburg, Germany
| | | | - Joachim Dissemond
- Department for Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
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16
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Bolt HM, Hengstler JG. Tattoo toxicology, an upcoming complex scientific issue. Arch Toxicol 2020; 94:2273-2274. [PMID: 32607612 PMCID: PMC7367905 DOI: 10.1007/s00204-020-02822-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Hermann M Bolt
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Adeystr. 67, 44139, Dortmund, Germany.
| | - Jan G Hengstler
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Adeystr. 67, 44139, Dortmund, Germany
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17
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Lim A, Tang PY, Oh CC. Lichen planus pemphigoides after body tattooing. J Cosmet Dermatol 2020; 19:3048-3052. [PMID: 32542984 DOI: 10.1111/jocd.13553] [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: 05/30/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 11/27/2022]
Abstract
Decorative tattooing is very popular worldwide and is associated with cutaneous complications, ranging from infections to localized or generalized skin reactions. We report a case of a patient presenting with generalized violaceous pruritic papular lesions 1 month after obtaining a black ink tattoo. Histological examination of a papular lesion distal to the tattoo site showed focal band-like lymphocytic infiltrate. He subsequently developed bullae over the papular lesions, with elevated serum BP180 antibody levels. A diagnosis of generalized lichen planus and lichen planus pemphigoides was made. He responded to treatment with potent topical corticosteroids and ciclosporin. We also reviewed the presentation and treatment of published cases of lichenoid reactions in the literature. With the increasing popularity of tattoos, awareness of this potential complication and possible treatments is important.
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Affiliation(s)
- Agnes Lim
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Po Yin Tang
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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18
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Bagot M. [Complications of tattoos: Clinical and pathological classification, pathophysiology, particle kinetics]. BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE 2020; 204:607-610. [PMID: 32322105 PMCID: PMC7172802 DOI: 10.1016/j.banm.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/10/2020] [Indexed: 11/24/2022]
Abstract
Les tatouages sont de plus en plus fréquents et leur surface est en augmentation. Ils sont également de plus en plus colorés. Les complications sont fréquentes et réalisent des tableaux cliniques et histologiques très variés. Les encres, dont la composition n’est pas toujours connue, contiennent de nombreux pigments dont les produits de dégradation peuvent entraîner des allergies chroniques. Les effets à long terme de la présence de produits carcinogènes et de nanoparticules justifient la réalisation d’études prospectives. Le public devrait être informé de ces complications et des difficultés du détatouage.
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Affiliation(s)
- M Bagot
- Unité Inserm U976, service de dermatologie, université de Paris, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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19
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Giulbudagian M, Schreiver I, Singh AV, Laux P, Luch A. Safety of tattoos and permanent make-up: a regulatory view. Arch Toxicol 2020; 94:357-369. [DOI: 10.1007/s00204-020-02655-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/29/2020] [Indexed: 12/19/2022]
Abstract
AbstractThe continuous increase in the popularity of tattoos and permanent make-up (PMU) has led to substantial changes in their societal perception. Besides a better understanding of pathological conditions associated with the injection of highly diverse substances into subepidermal layers of the skin, their regulation has occupied regulatory bodies around the globe. In that sense, current regulatory progress in the European Union is an exemplary initiative for improving the safety of tattooing. On one hand, the compilation of market surveillance data has provided knowledge on hazardous substances present in tattoo inks. On the other hand, clinical data gathered from patients enabled correlation of adverse reactions with certain substances. Nevertheless, the assessment of risks remains a challenge due to knowledge gaps on the biokinetics of highly complex inks and their degradation products. This review article examines the strategies for regulating substances in tattoo inks and PMU in light of their potential future restriction in the frame of the REACH regulation. Substance categories are discussed in terms of their risk assessment and proposed concentration limits.
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