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Giulbudagian M, Battisini B, Bäumler W, Blass Rico AM, Bocca B, Brungs C, Famele M, Foerster M, Gutsche B, Houben V, Hauri U, Karpienko K, Karst U, Katz LM, Kluger N, Serup J, Schreiver I, Schubert S, van der Bent SAS, Wolf C, Luch A, Laux P. Lessons learned in a decade: Medical-toxicological view of tattooing. J Eur Acad Dermatol Venereol 2024. [PMID: 38709160 DOI: 10.1111/jdv.20072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/15/2024] [Indexed: 05/07/2024]
Abstract
Tattooing has been part of the human culture for thousands of years, yet only in the past decades has it entered the mainstream of the society. With the rise in popularity, tattoos also gained attention among researchers, with the aim to better understand the health risks posed by their application. 'A medical-toxicological view of tattooing'-a work published in The Lancet almost a decade ago, resulted from the international collaboration of various experts in the field. Since then, much understanding has been achieved regarding adverse effects, treatment of complications, as well as their regulation for improving public health. Yet major knowledge gaps remain. This review article results from the Second International Conference on Tattoo Safety hosted by the German Federal Institute for Risk Assessment (BfR) and provides a glimpse from the medical-toxicological perspective, regulatory strategies and advances in the analysis of tattoo inks.
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Affiliation(s)
- Michael Giulbudagian
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Beatrice Battisini
- Department of Environment and Health, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Wolfgang Bäumler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - Ana M Blass Rico
- European Commission, DG Internal Market, Industry, Entrepreneurship and SMEs (GROW), Brussels, Belgium
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Corinna Brungs
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Marco Famele
- National Centre for Chemicals, Cosmetic Products and Consumer's Health Protection - Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Milena Foerster
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Birgit Gutsche
- Karlsruhe Chemical and Veterinary Investigation Authority, Karlsruhe, Germany
| | | | - Urs Hauri
- Kanton Basel-Stadt, Kantonales Laboratorium, Basel, Switzerland
| | - Katarzyna Karpienko
- Department of Metrology and Optoelectronics, Faculty of Electronics, Telecommunication, and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Linda M Katz
- Office of Cosmetics and Colors, United States Food and Drug Administration (FDA), College Park, Maryland, USA
| | - Nicolas Kluger
- Department of Dermatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- "Tattoo Consultation", Department of Dermatology, Bichat - Claude Bernard Hospital, Paris, France
- EADV Tattoo and Body Art Task Force, Lugano, Switzerland
| | - Jørgen Serup
- Department of Dermatology, the Tattoo Clinic, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology - IVDK, Institute at the University Medical Center Göttingen, Göttingen, Germany
| | | | - Carina Wolf
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Peter Laux
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Latoni DI, Foreman RK, Lavigne K, Busam KJ, Tsao H. Multiple de novo spitzoid nevi arising within a specific red tattoo ink. JAAD Case Rep 2024; 46:78-80. [PMID: 38577501 PMCID: PMC10992272 DOI: 10.1016/j.jdcr.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Affiliation(s)
- David I. Latoni
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Tufts University School of Medicine, Boston, Massachusetts
| | - Ruth K. Foreman
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Klaus J. Busam
- Deparment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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3
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Sozer Karadagli S, Kaftan G, Cansever I, Armagan G, Sogut O. Tattoo inks: evaluation of cellular responses and analysis of some trace metals. Biometals 2024; 37:495-505. [PMID: 38038794 DOI: 10.1007/s10534-023-00564-z] [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: 08/11/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023]
Abstract
After tattoo application, inks remain in the skin, mostly in the dermal layer, and manufacturers use inks that have not been adequately evaluated for safety in tattoo production. In this study, the metal contents (Cd, Hg, Pb, and Cr) of tattoo inks available in the Turkish market were determined and the relationship between cell viability and inflammatory response of the detected metal levels was investigated. Nine tattoo inks (3 colors) from 3 different brands abbreviated as E, I, and W were examined. ICP-MS was used for element analysis. The viability of human keratinocyte cells was determined by the WST-1 assay following ink exposures at various dilutions. IL-18 levels were measured in cell culture supernatant by ELISA method following ink or metal (Cd, Cr, Hg, and Pb) exposures. The concentrations of trace elements were found in inks as follows: Cd, 0.0641-1.3857; Hg, 0.0204-0.2675; Pb, 0.8527-6.5981; Cr, 0.1731-45.3962 µg mL-1. It was observed that the levels of Pb and especially Cr in the samples exceeded the limit values. Tattoo inks reduced the cell viability in a dose- and color-dependent manner. IL-18 release was significantly increased in all groups except Cr and black ink of brand I treated cells (p < 0.05). Our results show that the metal contents of tattoo inks exceed Council of Europe Resolution values in some samples and some inks induce immune system activation (IL-18 secretion) and cytotoxic effects. It is thought that these findings may contribute to the toxic/adverse effects of tattoo inks commonly used.
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Affiliation(s)
- Sumru Sozer Karadagli
- Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ege University, Izmir, Turkey.
| | - Gizem Kaftan
- Faculty of Pharmacy, Department of Biochemistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Islam Cansever
- Central Research Laboratories, Katip Celebi University, Izmir, Turkey
| | - Guliz Armagan
- Faculty of Pharmacy, Department of Biochemistry, Ege University, Izmir, Turkey
| | - Ozlem Sogut
- Faculty of Pharmacy, Department of Analytical Chemistry, Ege University, Izmir, Turkey
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Zhao H, Chen Z, Kang X, Yang B, Luo P, Li H, He Q. The frontline of alternatives to animal testing: novel in vitro skin model application in drug development and evaluation. Toxicol Sci 2023; 196:152-169. [PMID: 37702017 DOI: 10.1093/toxsci/kfad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
The FDA Modernization Act 2.0 has brought nonclinical drug evaluation into a new era. In vitro models are widely used and play an important role in modern drug development and evaluation, including early candidate drug screening and preclinical drug efficacy and toxicity assessment. Driven by regulatory steering and facilitated by well-defined physiology, novel in vitro skin models are emerging rapidly, becoming the most advanced area in alternative testing research. The revolutionary technologies bring us many in vitro skin models, either laboratory-developed or commercially available, which were all built to emulate the structure of the natural skin to recapitulate the skin's physiological function and particular skin pathology. During the model development, how to achieve balance among complexity, accessibility, capability, and cost-effectiveness remains the core challenge for researchers. This review attempts to introduce the existing in vitro skin models, align them on different dimensions, such as structural complexity, functional maturity, and screening throughput, and provide an update on their current application in various scenarios within the scope of chemical testing and drug development, including testing in genotoxicity, phototoxicity, skin sensitization, corrosion/irritation. Overall, the review will summarize a general strategy for in vitro skin model to enhance future model invention, application, and translation in drug development and evaluation.
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Affiliation(s)
- He Zhao
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Zhaozeng Chen
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, Hangzhou 310018, China
| | - Xingchen Kang
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Bo Yang
- Institute of Pharmacology & Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Peihua Luo
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, Hangzhou 310018, China
| | - Hui Li
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, Hangzhou 310018, China
| | - Qiaojun He
- Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Artificial Intelligence in Medicine of Zhejiang University, Hangzhou 310018, China
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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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Complete Genome Sequence of Metabacillus litoralis Strain NCTR108, Isolated from Commercial Tattoo Ink. Microbiol Resour Announc 2022; 11:e0079422. [PMID: 36197283 PMCID: PMC9670996 DOI: 10.1128/mra.00794-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Metabacillus litoralis is part of the newly proposed genus Metabacillus. The bacterium was first isolated from a Yellow Sea tidal flat in 2005. As of May 2022, there are five genomic assemblies deposited in GenBank. We report the 5.2-Mbp genome sequence of M. litoralis strain NCTR108, from commercial tattoo ink.
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“For Asia Market Only”: A Green Tattoo Ink between Safety and Regulations. Molecules 2022; 27:molecules27113491. [PMID: 35684430 PMCID: PMC9182426 DOI: 10.3390/molecules27113491] [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] [Received: 04/22/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022] Open
Abstract
Due to the increasing tattoo practicing in Eastern countries and general concern on tattoo ink composition and safety, the green tattoo inks Green Concentrate by Eternal, for European and “for Asia Market Only” were analyzed, under the premise that only the former falls under a composition regulation. A separation of the additives from the pigment was carried out by successive extraction in solvents of different polarities, i.e., water, acetone and dichloromethane. The solid residues were analyzed by IR and Raman spectroscopies, the liquid fractions by GC/mass spectrometry. The relative pigment load and element traces were also estimated. We found that the European and the Asian inks are based on the same pigment, PG7, restricted in Europe, though at different loads. They have a similar content of harmful impurities, such as Ni, As, Cd and Sb and both contain siloxanes, including harmful D4. Furthermore, they have different physical-chemical properties, the European ink being more hydrophilic, the Asian more hydrophobic. Additionally, the Asian ink contains harmful additives for the solubilization of hydrophobic matrices and by-products of the phthalocyanine synthesis. Teratogenic phthalates are present as well as chlorinated teratogenic and carcinogenic compounds usually associated to the laser treatment for removal purposes, to a larger extent in the European ink. The composition of the inks does not seem to reflect regulatory restrictions, where issued.
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Negi S, Bala L, Shukla S, Chopra D. Tattoo inks are toxicological risks to human health: A systematic review of its ingredients, fate inside skin, toxicity due to polycyclic aromatic hydrocarbons, primary aromatic amines, metals, and overview of regulatory frameworks. Toxicol Ind Health 2022; 38:417-434. [PMID: 35592919 DOI: 10.1177/07482337221100870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Today, tattooing has become very popular among people all over the world. Tattooists, with the help of tiny needles, place tattoo ink inside the skin surface and unintentionally introduce a large number of unknown ingredients. These ingredients include polycyclic aromatic hydrocarbons (PAHs), heavy metals, and primary aromatic amines (PAAs), which are either unintentionally introduced along with the ink or produced inside the skin by different types of processes for example cleavage, metabolism and photodecomposition. These could pose toxicological risks to human health, if present beyond permissible limits. PAH such as Benzo(a)pyrene is present in carbon black ink. PAAs could be formed inside the skin as a result of reductive cleavage of organic azo dyes. They are reported to be highly carcinogenic by environmental protection agencies. Heavy metals, namely, cadmium, lead, mercury, antimony, beryllium, and arsenic are responsible for cancer, neurodegenerative diseases, cardiovascular, gastrointestinal, lungs, kidneys, liver, endocrine, and bone diseases. Mercury, cobalt sulphate, other soluble cobalt salts, and carbon black are in Group 2B, which means they may cause cancer in humans. Cadmium and compounds of cadmium, on the other hand, are in Group 1 (carcinogenic to humans). The present article addresses the various ingredients of tattoo inks, their metabolic fate inside human skin and unintentionally added impurities that could pose toxicological risk to human health. Public awareness and regulations that are warranted to be implemented globally for improving the safety of tattooing.
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Affiliation(s)
- Sandeep Negi
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Lakshmi Bala
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India
| | - Saumya Shukla
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Deepti Chopra
- Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
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Jet injectors: Perspectives for small volume delivery with lasers. Adv Drug Deliv Rev 2022; 182:114109. [PMID: 34998902 DOI: 10.1016/j.addr.2021.114109] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 12/27/2022]
Abstract
Needle-free jet injectors have been proposed as an alternative to injections with hypodermic needles. Currently, a handful of commercial needle-free jet injectors already exist. However, these injectors are designed for specific injections, typically limited to large injection volumes into the deeper layers beneath the skin. There is growing evidence of advantages when delivering small volumes into the superficial skin layers, namely the epidermis and dermis. Injections such as vaccines and insulin would benefit from delivery into these superficial layers. Furthermore, the same technology for small volume needle-free injections can serve (medical) tattooing as well as other personalized medicine treatments. The research dedicated to needle-free jet injectors actuated by laser energy has increased in the last decade. In this case, the absorption of the optical energy by the liquid results in an explosively growing bubble. This bubble displaces the rest of the liquid, resulting in a fast microfluidic jet which can penetrate the skin. This technique allows for precise control over volumes (pL to µL) and penetration depths (µm to mm). Furthermore, these injections can be tuned without changing the device, by varying parameters such as laser power, beam diameter and filling level of the liquid container. Despite the published research on the working principles and capabilities of individual laser-actuated jet injectors, a thorough overview encompassing all of them is lacking. In this perspective, we will discuss the current status of laser-based jet injectors and contrast their advantages and limitations, as well as their potential and challenges.
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