1
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Shin J, Leger M. Tattoo pruritus successfully treated with ruxolitinib: A case series. JAAD Case Rep 2024; 47:107-109. [PMID: 38699580 PMCID: PMC11063527 DOI: 10.1016/j.jdcr.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Affiliation(s)
| | - Marie Leger
- Assistant Professor of Dermatology at Mount Sinai, Entière Dermatology, New York, New York
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2
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Liszewski W, Newcomer J, Laumann AE, Leger MC, Farah RS. An Analysis of the Content and Recommendations of 700 American Tattoo Aftercare Instructions. Dermatology 2023; 239:988-995. [PMID: 37604151 DOI: 10.1159/000533489] [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: 11/23/2022] [Accepted: 07/06/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Tattoo aftercare instructions describe how to care for a new tattoo. Unfortunately, tattoo artists often base their advice on personal experience rather than best practices in medical wound management. The diversity of recommendations in these instructions is currently unknown. OBJECTIVES Our review was performed to determine current recommendations in tattoo aftercare instructions in the United States. METHODS Using a Google search, a total of 700 aftercare instructions from all 50 states and Washington D.C. were collected and their contents analyzed. RESULTS Most instructions encouraged washing new tattoos with antibiotic soaps, including chlorhexidine, and 14.9% encouraged using topical antibiotics. Few instructed individuals to wash their hands before touching a healing tattoo. A total of 70 moisturizers were recommended. Of these, 22 were niche products made specifically for tattoo aftercare. Only a subset of instructions provided parameters about when to contact the tattooist (49.9%) and/or a physician (19.4%) should there be a complication in the healing process. CONCLUSION The content and recommendations of the 700 instructions vary tremendously. Many lacked instructions on appropriate hygiene and when to seek medical care. As skin and wound care experts, there may be an opportunity for the dermatology community to partner with tattooists to create more useful evidence-based tattoo aftercare practices.
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Affiliation(s)
- Walter Liszewski
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - Jack Newcomer
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - Anne E Laumann
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - Marie C Leger
- Entiere Dermatology and Mount Sinai, New York City, New York, USA
| | - Ronda S Farah
- University of Minnesota, Minneapolis, Minnesota, USA
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3
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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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4
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Wollina U. Inflammatory reaction to recently applied red tattoo ink after COVID-19. J Cosmet Dermatol 2022; 21:7237-7239. [PMID: 36106520 PMCID: PMC9538287 DOI: 10.1111/jocd.15389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and AllergologyStädtisches Klinikum Dresden, Academic Teaching HospitalDresdenGermany
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5
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Szulia A, Antoszewski B, Zawadzki T, Kasielska-Trojan A. When Body Art Goes Awry-Severe Systemic Allergic Reaction to Red Ink Tattoo Requiring Surgical Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10741. [PMID: 36078458 PMCID: PMC9517851 DOI: 10.3390/ijerph191710741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
The aim of this report is to present a case of a patient who developed unusual systemic hypersensitivity reaction to a red-pigmented tattoo and to discuss diagnostic difficulties in case of systemic reactions to tattoo ink. The patient reported erythroderma on his arms and chest accompanied by plaque elevation of red parts of his most recently performed forearm tattoo as his primary symptoms. His health condition entailed a prolonged topical and intravenous immunosuppressive therapy, which proved ineffective. Over a year after emergence of initial symptoms, he presented to the Plastic Surgery Clinic with generalized erythroderma, systemic lymphadenopathy, elevation and granuloma formation in red tattoos on his forearm and complaints of fatigue and inability to participate fully in work-related and social activities. The patient underwent six staged excisions with direct closures, flap plasties and full-thickness skin grafts. Following completion of each surgical resection, the patient's symptoms gradually subsided. We find this case illustrative of a clinical challenge that delayed hypersensitivity reactions to red tattoos may pose. Furthermore, we provide insights on management of hypersensitivity reactions. This report underlines the importance of social awareness of and public health approach to tattoo complications as key to successful prevention, identification and treatment of adverse reactions to tattoos.
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Affiliation(s)
- Agata Szulia
- The Military Medical Faculty, Medical University of Lodz, 90-419 Lodz, Poland
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Tomasz Zawadzki
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
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6
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Fraser TR, Ross KE, Alexander U, Lenehan CE. Current knowledge of the degradation products of tattoo pigments by sunlight, laser irradiation and metabolism: a systematic review. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:343-355. [PMID: 34274958 DOI: 10.1038/s41370-021-00364-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
The popularity of tattooing has increased significantly over recent years. This has raised concerns about the safety of tattoo inks and their metabolites/degradation products. The photolytic and metabolic degradation of tattoo pigments may result in the formation of toxic compounds, with unforeseen health risks. A systematic literature review was undertaken to determine the current state of knowledge of tattoo pigments' degradation products when irradiated with sunlight, laser light or metabolised. The review demonstrates that there is a lack of knowledge regarding tattoo pigment degradation/metabolism, with only eleven articles found pertaining to the photolysis of tattoo pigments and two articles on the metabolism of tattoo pigments. The limited research indicates that the photolysis of tattoo pigments could result in many toxic degradation products, including hydrogen cyanide and carcinogenic aromatic amines.
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Affiliation(s)
- Tristan R Fraser
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
| | - Kirstin E Ross
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
| | - Ula Alexander
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
| | - Claire E Lenehan
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia.
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7
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Rogowska P, Walczak P, Wrzosek-Dobrzyniecka K, Nowicki RJ, Szczerkowska-Dobosz A. Tattooing in Psoriasis: A Questionnaire-Based Analysis of 150 Patients. Clin Cosmet Investig Dermatol 2022; 15:587-593. [PMID: 35418768 PMCID: PMC8995150 DOI: 10.2147/ccid.s348165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022]
Abstract
Purpose Among populations of Western countries, tattoos have become an accepted form of skin ornamenting. With tattoos growing in popularity, also patients suffering from chronic dermatoses may more often be willing to get tattooed. Psoriasis is not considered as a strict contraindication for tattooing; however, it is not advised to get a tattoo while undergoing immunosuppressive treatment and during an active stage of the disease. We attempted to assess the knowledge level of tattooed psoriatic patients about the potential risks connected with tattooing, as well as to explore their attitudes and tendencies towards this procedure. Moreover, we analyzed the frequency and type of tattoo complications in this study group. Patients and Methods An anonymous, online questionnaire was performed among online communities dedicated to psoriasis. Data from 150 tattooed psoriatic patients have been scrutinized. Results Eight percent of the surveyed psoriatic patients sought medical advice before getting a tattoo. While undergoing the tattooing procedure, 23 (15.3%) of the respondents received systemic psoriasis treatment: 8 (5.3%) being treated with methotrexate, 5 (3.3%) with cyclosporine A, one (0.7%) acitretin, and 9 (6%) patients were under biological treatment. Thirteen (8.7%) of the participants experienced complications associated with their tattoos, among which, the insurgence of the Koebner phenomenon on the tattoo, was the most frequent one (8 cases- 5.3%). Getting tattooed improved patients' self-esteem in 76 (50.7%) of the cases. Conclusion An increased level of education among patients, medical practitioners, and tattooists concerning general precautions of tattooing in psoriasis is advisable.
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Affiliation(s)
- Patrycja Rogowska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Paula Walczak
- Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Aneta Szczerkowska-Dobosz
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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8
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Rogowska P, Sobjanek M, Sławińska M, Nowicki RJ, Szczerkowska-Dobosz A. Tattoos Dermatological Complications: Analysis of 53 Cases from Northern Poland. Dermatology 2021; 238:799-806. [PMID: 34969030 DOI: 10.1159/000520752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 11/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The frequency of tattoos varies from 10% to 30% across the population worldwide. The growing popularity of tattooing increases the number of cutaneous reactions connected with this procedure. As we have not found any previous studies in the literature concerning tattoo complications in Poland and other Eastern European countries, we believe this to be the first study of this kind. OBJECTIVE The primary objective of this study was to evaluate the clinical spectrum of complications associated with the procedure of permanent tattooing among patients from Northern Poland. METHODS Medical data of 53 patients who developed tattoo-related cutaneous conditions were analyzed. All of the patients were consulted in the Dermatology, Venereology and Allergology Clinic in Gdańsk in the years 2018-2021. Medical history, dermatological assessment, and photographic documentation of skin lesions were performed in each case. Dermoscopic examination was carried out in 16 cases and 20 skin biopsies of the tattoo reactions were performed. RESULTS Twenty-one patients (40%) presented tattoo ink hypersensitivity reactions, out of which 18 were triggered by the red ink. In 11 cases (21%), contact dermatitis has developed after tattooing, while 9 of the patients (17%) presented tattoo infectious complications, including local bacterial infections, common warts, molluscum contagiosum, and demodicosis. We collected 8 cases (15%) of papulonodular reactions in black tattoos, and in 6 of them, histology showed granuloma formation. In 2 cases (4%), symptoms of anaphylaxis were observed after the tattooing procedure, and in another 2 cases (4%), Koebner phenomenon in the tattoo was diagnosed. Dermoscopy was the clue to the diagnosis in 4 cases. CONCLUSIONS This is the first report presenting multiple cases of tattoo complications from Eastern Europe. The results of the study are consistent with other researches, showing a similar distribution of tattoo complications and that across the different pigments used, the red ink is most frequently responsible for tattoo reactions. We emphasize the usefulness of dermoscopic examination in the diagnosis of tattoo-related infections and draw the reader's attention to the rare, yet hazardous complications connected with peri-tattooing anaphylaxis.
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Affiliation(s)
- Patrycja Rogowska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Aneta Szczerkowska-Dobosz
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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9
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Battistini B, Petrucci F, De Angelis I, Failla CM, Bocca B. Quantitative analysis of metals and metal-based nano- and submicron-particles in tattoo inks. CHEMOSPHERE 2020; 245:125667. [PMID: 31877461 DOI: 10.1016/j.chemosphere.2019.125667] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/15/2019] [Accepted: 12/13/2019] [Indexed: 06/10/2023]
Abstract
Exposure to metals and metal-based nano- (NPs, 1-100 nm) and submicron-particles (SPs, 0.1-1 μm) contained in tattoo inks and related health safety is currently receiving a great deal of interest. Twenty inks of different brands and colours were sampled in Italy in 2019. The SemiQuant Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis allowed quantifying the concentration of 18 metals (Al, As, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Sb, Se, Sn, Ti, Zn) in inks. The Single Particle ICP-MS was used to detect the diameters and concentration of NPs and SPs of 9 metals (Al, Co, Cr, Cu, Hg, Ni, Pb, Ti and Zn). Concentration of metals in tattoo inks were below the recommended concentrations reported in the Resolution ResAP (2008)1 indicating ink production have shifted to purer materials and best manufacturing practices. Regarding particles, Al was found at nano- (62-80 nm) and submicron-sizes (105-140 nm). Sizes of Cr, Cu, Pb and Zn were in the intervals 42-62 nm, 44-96 nm, 26-28 nm and 26-59 nm, respectively. Titanium was at submicron-diameters (166-383 nm). In addition, Cr and Ti particles accounted for the 47% and 80% of their total concentration, respectively. Tattooing practice exposed humans to metal-based NPs and SPs and the presence of a combination of particles of different metals and/or their dynamics (e.g., dissolution) may change their bioavailability and toxicity.
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Affiliation(s)
- Beatrice Battistini
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesco Petrucci
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Isabella De Angelis
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Cristina Maria Failla
- Experimental Immunology Laboratory, Istituto Dermopatico dell'Immacolata, Via Monti di Creta 104, 00167, Roma, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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10
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Hutton Carlsen K, Larsen G, Serup J. Tattoo pigment agglomerates measured in skin biopsies by computerised light microscopy: Study of 161 patients with adverse reactions in black and red tattoos. Skin Res Technol 2019; 26:284-291. [PMID: 31799768 DOI: 10.1111/srt.12798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Black tattoo reactions are suggested to be foreign body reactions manifested as papulo-nodular inflammation that is associated with active sarcoidosis. AIM To study the morphology of black and red pigment agglomerates in skin biopsies from tattoo reactions, referenced to clinical diagnoses. METHOD Agglomerate count, area, width, height, circumference and circularity were measured in 161 patients by light microscopy (Olympus BX51™); 161 unstained skin biopsies from 64 black tattoo reactions and 97 reactions in red tattoos with allergy. Images (Jenoptic Gryphax RGB camera) were taken through a 40× objective using immersion oil. Computerised analysis of agglomerates was performed using ImageJ software. Student t test, chi-square test, Fisher Exact test, ANOVA and Bonferroni tests were applied. RESULTS Comparison of black and red pigment agglomerates showed no overall differences in count, area, width, height or circumference. However, in black tattoo reactions, the count of agglomerates was higher in patients with sarcoidosis (P = .009) vs no sarcoidosis. Black agglomerates were more circular shaped as compared to red, P = .023. In red tattoo reactions, agglomerates in patients with allergic cross-reactivity were slightly more circular (P = .036) vs patients with milder allergy. The count of red agglomerates was lower in patients clinically typed excessive hyperkeratosis (P = .041) compared with other clinical types of allergy. CONCLUSION Patients with reactions in black tattoos associated with sarcoidosis have increased count of pigment agglomerates vs those without associated sarcoidosis indicating that black pigment agglomeration is one among a number of factors triggering sarcoid tattoo complication. Circular shape of agglomerates may code for bioactivity.
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Affiliation(s)
- Katrina Hutton Carlsen
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Jørgen Serup
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark
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11
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van der Bent SAS, Engel MJC, Nossent EJ, Jonkers RE, Wolkerstorfer A, Rustemeyer T. Tattoos and self-reported adverse events in sarcoidosis patients. J Eur Acad Dermatol Venereol 2019; 34:e167-e169. [PMID: 31773784 DOI: 10.1111/jdv.16115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S A S van der Bent
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M J C Engel
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - E J Nossent
- Department of Pulmonology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - R E Jonkers
- Department of Pulmonology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - A Wolkerstorfer
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - T Rustemeyer
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
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12
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Abstract
Introduction: Decorative tattooing involves the introduction of exogenous pigments and/or dyes into the dermis to produce a permanent design.Areas covered: This review provides an overview of the current aspects of cutaneous complications associated with permanent tattooing and permanent make-up based on the previous reviews of interest, case series, and case reports of interest. References for this review were found through a search of PubMed by use of the terms 'tattoo', 'tattoos', or 'tattooing'.Expert opinion: Complications include primarily infections, allergy to tattoo pigments, benign, and sometimes malignant tumors arising on tattoos and the localization of various dermatoses to tattoos. Immunocompromised patients and individuals with chronic conditions should be able to discuss with their physician and ask advice before getting tattooed. Tattoo color allergy still remains an unsolved issue. The identification of current culprit failed. It is most likely a byproduct that appears in situ in the skin during the life of the tattooed bearer. Studies involving expert centers are warranted to establish the best treatments for tattoo allergy. The risk of tattoo associated cancers appears to this author as largely overstated. However, case controls studies on large on cohorts of individuals with or without tattoos could help to evaluate whether tattoos have a possible in role in cancers.
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Affiliation(s)
- Nicolas Kluger
- Department of dermatology, allergology and venereology, Helsinki University Central Hospital, Helsinki, Finland.,"Tattoo" Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
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13
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Kluger N. Tattoo side effects worldwide: a Google Trends–based time series analysis. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Tattoos in der deutschen Bevölkerung – Prävalenzen, Soziodemografie und Gesundheitsorientierung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1077-1082. [DOI: 10.1007/s00103-019-02999-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Glamour, expression, and consequences of tattoos in radiation treatment. PLoS One 2019; 14:e0220030. [PMID: 31390347 PMCID: PMC6685677 DOI: 10.1371/journal.pone.0220030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 07/08/2019] [Indexed: 12/03/2022] Open
Abstract
It is estimated that approximately 24% of the US population has at least one tattoo. However, tattoo ink ingredients include heavy metals (high atomic number Z) that are not regulated, which can cause skin reactions. This study investigates the dosimetric effects in surface dose due to high-Z elements in tattoo ink under electron beam irradiation. Four commercially available tattoo ink colors, black, red, yellow, and blue were chosen. The elemental composition of the tattoo ink samples was analyzed using X-ray Fluorescence (XRF). An ultrathin-window parallel plate ion chamber was used to measure the surface dose perturbation (ratio of ionizations with and without tattoo ink) for 6 − 20 MeV electron beams. The elemental concentration in the tattoo ink samples showed high-Z elements, with Z ranging from 11 to 92. The dose perturbation ranged from 1.4% up to 6% for the yellow ink for the 6 MeV electron beam, with similar values across the rest of the electron energies, whereas the black, red, and blue inks presented up to 3% dose perturbation for the same range of energies. Based on this initial study, we conclude that commercially available tattoo inks contain large amounts of high-Z metals that may contribute to dose perturbation. Therefore treatment of superficial lesions with electron beams in a tattooed area should be monitored for signs of early skin reaction during radiation therapy treatments.
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16
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Adverse reactions to tattoos in the general population of Denmark. J Am Acad Dermatol 2018; 79:770-772. [DOI: 10.1016/j.jaad.2018.03.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/23/2018] [Accepted: 03/27/2018] [Indexed: 11/21/2022]
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17
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Navrazhina K, Goldman B, Leger MC. Atypical Intraepidermal Melanocytic Proliferation Masked by a Tattoo: Implications for Tattoo Artists and Public Health Campaigns. Cureus 2018; 10:e2975. [PMID: 30225182 PMCID: PMC6138458 DOI: 10.7759/cureus.2975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Tattoos have become increasingly popular worldwide. While tattoos carry a minimal risk of complications, previous reports have located malignant melanoma hidden within tattoos. We present a case of an atypical intraepidermal melanocytic proliferation masked by a large tattoo in a 39-year-old Caucasian male. Tattooed skin can be difficult to examine, particularly when the tattoos are dark, pigmented, and extensive. We demonstrate that a careful examination of tattooed skin leads to the early detection of atypical melanocytic proliferations. We present an extensive review of literature related to the relationship between tattoos and skin cancer, as well as public health recommendations for tattoo artists and individuals seeking to obtain tattoos. We urge a vigilant examination of tattooed skin and encourage collaboration between dermatologists and tattoo artists in promoting the detection of suspicious lesions prior and following tattooing.
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Affiliation(s)
| | - Barry Goldman
- Dermatology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, USA
| | - Marie C Leger
- Dermatology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, USA
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18
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Schreiver I, Hesse B, Seim C, Castillo-Michel H, Villanova J, Laux P, Dreiack N, Penning R, Tucoulou R, Cotte M, Luch A. Synchrotron-based ν-XRF mapping and μ-FTIR microscopy enable to look into the fate and effects of tattoo pigments in human skin. Sci Rep 2017; 7:11395. [PMID: 28900193 PMCID: PMC5595966 DOI: 10.1038/s41598-017-11721-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022] Open
Abstract
The increasing prevalence of tattoos provoked safety concerns with respect to particle distribution and effects inside the human body. We used skin and lymphatic tissues from human corpses to address local biokinetics by means of synchrotron X-ray fluorescence (XRF) techniques at both the micro (μ) and nano (ν) scale. Additional advanced mass spectrometry-based methodology enabled to demonstrate simultaneous transport of organic pigments, heavy metals and titanium dioxide from skin to regional lymph nodes. Among these compounds, organic pigments displayed the broadest size range with smallest species preferentially reaching the lymph nodes. Using synchrotron μ-FTIR analysis we were also able to detect ultrastructural changes of the tissue adjacent to tattoo particles through altered amide I α-helix to β-sheet protein ratios and elevated lipid contents. Altogether we report strong evidence for both migration and long-term deposition of toxic elements and tattoo pigments as well as for conformational alterations of biomolecules that likely contribute to cutaneous inflammation and other adversities upon tattooing.
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Affiliation(s)
- Ines Schreiver
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Bernhard Hesse
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Christian Seim
- Physikalisch-Technische Bundesanstalt, Department of X-ray Spectrometry, Abbestrasse 2-12, 10587, Berlin, Germany.,Technische Universität Berlin, Institute for Optics and Atomic Physics, Hardenbergstrasse 36, 10623, Berlin, Germany
| | | | - Julie Villanova
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Nadine Dreiack
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Randolf Penning
- Institute of Forensic Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Remi Tucoulou
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Marine Cotte
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany.
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Bø K, Skullerud KH, Mengshoel AT, Eldholm V, Brantsæter AB. [Tattooed norwegian tourist with fever and rashes]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2017; 137:205-207. [PMID: 28181759 DOI: 10.4045/tidsskr.16.0710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Kristine Bø
- Seksjon for hudsykdommer Oslo universitetssykehus, Rikshospitalet
| | - Kristin Helene Skullerud
- Seksjon for hudsykdommer Oslo universitetssykehus, Rikshospitalet * Nåværende adresser: K.H. Skullerud, Olafiaklinikken, Seksjon for venerologi Oslo universitetssykehus
| | - Anne Torunn Mengshoel
- Avdeling for mikrobiologi Oslo universitetssykehus A.T. Mengshoel, Nasjonalt referanselaboratorium for mykobakterier Folkehelseinstituttet
| | | | - Arne Broch Brantsæter
- Infeksjonsmedisinsk avdeling Oslo universitetssykehus, Ullevål og Nasjonal behandlingstjeneste for CBRNE-medisin Oslo universitetssykehus
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Müller CSL, Oertel A, Körner R, Pföhler C, Vogt T. Socio-epidemiologic aspects and cutaneous side effects of permanent tattoos in Germany - Tattoos are not restricted to a specific social phenotype. DERMATO-ENDOCRINOLOGY 2016; 9:e1267080. [PMID: 28405265 PMCID: PMC5386101 DOI: 10.1080/19381980.2016.1267080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 11/30/2022]
Abstract
Background: More and more people of all age classes have a tattoo. Intriguingly, there are multiple prejudices in the general population and published data that concern tattooed persons, such as being criminals, having a low education, being alcohol or drug abusers, or more risky in their life style. Objective: To obtain and to evaluate sociodemographic data on tattooed persons, to investigate the incidence of tattoo-related cutaneous complications and to define personal risk factors and course of the persons after being tattooed concerning behavior of personal environment. Patients and Methods: We interviewed 426 participants with already existing tattoos and 20 participants just before getting a new tattoo by using an online questionnaire. The participators were asked about socio-epidemiologic aspects of tattoos in general and special aspects of their own tattoo(s) in particular. There were no exclusion criteria. Results: Tattoos are interesting for people seeking popular body art, esp. university graduates and financially-secure individuals. 446 persons participated in this study. Most of the persons were female with a mean age of 35. Local pruritus around the tattooed area was the most common cutaneous side effect among the participants. 93.5% of the participants did not want a tattoo removal. Intriguingly, most of the participants experienced no career problems related to the tattoo(s). Limitations: The study population is not representative as we included only persons being tattooed prior to or getting newly tattooed. Furthermore, there is a potential selection bias as the participation in this study was voluntary. Only persons that felt involved by the flyer did answer the questionnaire. Conclusion: The present data shows that common tattooed persons are not low educated criminals with any drug or alcohol abuse or with risky life style. Nowadays being tattooed encompasses a kind of body art and displays a certain kind of lifestyle habit.
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Affiliation(s)
| | - Angela Oertel
- Städtisches Klinikum Karlsruhe, Department of Obstetrics and Gynecology , Germany
| | | | - Claudia Pföhler
- Saarland University Hospital, Department of Dermatology, Homburg/Saar , Germany
| | - Thomas Vogt
- Saarland University Hospital, Department of Dermatology, Homburg/Saar , Germany
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Rosenbaum BE, Milam EC, Seo L, Leger MC. Skin Care in the Tattoo Parlor: A Survey of Tattoo Artists in New York City. Dermatology 2016; 232:484-9. [DOI: 10.1159/000446345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/20/2016] [Indexed: 11/19/2022] Open
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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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Schreiver I, Luch A. At the dark end of the rainbow: data gaps in tattoo toxicology. Arch Toxicol 2016; 90:1763-5. [PMID: 27169852 PMCID: PMC4894929 DOI: 10.1007/s00204-016-1740-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/04/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany.
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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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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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