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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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Rahbarinejad Y, Guio-Aguilar P, Vu AN, Lo M, McTigue C, Nirenberg A, Rozen WM. Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review. J Clin Med 2023; 12:jcm12062424. [PMID: 36983424 PMCID: PMC10056737 DOI: 10.3390/jcm12062424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/09/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
The increasing popularity of tattooing has paralleled an increase in associated cutaneous reactions. Red ink is notorious for eliciting cutaneous reactions. A common reaction is pseudoepitheliomatous hyperplasia (PEH), which is a benign condition closely simulating squamous cell carcinoma (SCC). Differentiating PEH from SCC is challenging for pathologists and clinicians alike. The exact pathogenesis of these lesions secondary to red ink is not known, and there are no sources outlining diagnostic and treatment options and their efficacy. We present four study cases with different pathologies associated to red ink tattoos including lichenoid reaction, granulomatous reaction, PEH, and an SCC. Additionally, an extensive review of 63 articles was performed to investigate pathogenesis, diagnostic approaches, and treatment options. Hypotheses surrounding pathogenesis include but are not limited to the carcinogenic components of pigments, their reaction with UV and the traumatic process of tattooing. Pathogenesis seems to be multifactorial. Full-thickness biopsies with follow-up is the recommended diagnostic approach. There is no evidence of a single universally successful treatment for PEH. Low-dose steroids are usually tried following a step up in lack of clinical response. For SCC lesions, full surgical excision is widely used. A focus on clinicians' awareness of adverse reactions is key for prevention. Regulation of the unmonitored tattoo industry remains an ongoing problem.
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Affiliation(s)
- Yasmina Rahbarinejad
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Pedro Guio-Aguilar
- Plastic and Reconstructive Surgery, Peninsula Health, Melbourne, VIC 3199, Australia
| | - Anh Ngoc Vu
- Plastic and Reconstructive Surgery, Peninsula Health, Melbourne, VIC 3199, Australia
| | - Michael Lo
- Plastic and Reconstructive Surgery, Monash Health, Melbourne, VIC 3168, Australia
| | - Christine McTigue
- Dorevitch Pathology at Peninsula Health, Melbourne, VIC 3199, Australia
| | - Alex Nirenberg
- Dorevitch Pathology at Peninsula Health, Melbourne, VIC 3199, Australia
| | - Warren M Rozen
- Plastic and Reconstructive Surgery, Peninsula Health, Melbourne, VIC 3199, Australia
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Bourgeois P, Roman MM, Schweicher J, Lavoisier P, Maquet P, Karler C, Lizewski M, Fouarge A, Cuylits N, del Marmol V, Leduc O. Lymphatic Alterations Under Tattoos: Preliminary Reports of One Observational Study. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2023; 16:257-265. [PMID: 36733347 PMCID: PMC9888301 DOI: 10.2147/ccid.s393038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 01/28/2023]
Abstract
Background The number of people within the European population having at least one tattoo has increased notably and with it the number of tattoo-associated clinical complications. The injected inks are known to be removed by the lymphatic vessels and can be found in the draining lymph nodes. Aim of the Study To report our observations on the lymphatic drainages seen under tattoos using near infrared fluorescence imaging of these lymphatic vessels after the injection of indocyanine green. Material and Methods Indocyanine green was injected intradermally at the basis of the 20 tattooed area(s) in 19 subjects (nine women and ten men; mean age = 28.6). Ten subjects had only black tattoos (six upper limbs and four lower limbs), five (two upper limbs and three lower limbs) black and white tattoos and five multi-colored tattooed limbs (four lower limbs and one upper limb). Results The imaging exams revealed alterations in eight individuals, seven of whom had tattoos on their lower limbs. Furthermore, the imaging results showed that the abnormalities might be related to the tattooed limb, the tattoo extent and colour. Conclusion Alterations of the cutaneous lymphatic channels are frequently observed under tattooed territories. Their causal factors should be more precisely studied in future works and these lymphatic alterations should be considered in tattooed patients when using similar imaging techniques for therapeutic and surgical assessments.
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Affiliation(s)
- Pierre Bourgeois
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium,Services of Nuclear Medicine, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Multi-Disciplinary Clinic of Lymphology, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium,Service of Vascular Surgery, HIS-IZZ Hospitals, Université Libre de Bruxelles, Brussels, Belgium,Correspondence: Pierre Bourgeois, Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, 808, route de Lennik, Brussels, 1070, Belgium, Tel +32495201906, Email
| | - Mirela Mariana Roman
- Department of Mammo-Pelvic Surgery, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Justine Schweicher
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Pauline Lavoisier
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Philippe Maquet
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
| | - Clarence Karler
- Department of Anesthesia-Algologia, Hospital Moliere, Université Libre de Bruxelles, Brussels, Belgium
| | - Mateusz Lizewski
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Alessandro Fouarge
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Cuylits
- Service of Plastic, Reconstructive and Aesthetic Surgery, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Véronique del Marmol
- Service of Dermatology, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Leduc
- Unité de lympho-phlébologie, Haute Ecole Bruxelles-Brabant, Haute Ecole Robert Schuman, Brussels, Belgium
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Colboc H, Bazin D, Reguer S, Lucas IT, Moguelet P, Amode R, Jouanneau C, Soria A, Chasset F, Amsler E, Pecquet C, Aractingi S, Bellot-Gurlet L, Deschamps L, Descamps V, Kluger N. Chemical characterization of inks in skin reactions to tattoo. JOURNAL OF SYNCHROTRON RADIATION 2022; 29:1436-1445. [PMID: 36345752 PMCID: PMC9641572 DOI: 10.1107/s1600577522008165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Skin reactions are well described complications of tattooing, usually provoked by red inks. Chemical characterizations of these inks are usually based on limited subjects and techniques. This study aimed to determine the organic and inorganic composition of inks using X-ray fluorescence spectroscopy (XRF), X-ray absorption spectroscopy (XANES) and Raman spectroscopy, in a cohort of patients with cutaneous hypersensitivity reactions to tattoo. A retrospective multicenter study was performed, including 15 patients diagnosed with skin reactions to tattoos. Almost half of these patients developed skin reactions on black inks. XRF identified known allergenic metals - titanium, chromium, manganese, nickel and copper - in almost all cases. XANES spectroscopy distinguished zinc and iron present in ink from these elements in endogenous biomolecules. Raman spectroscopy showed the presence of both reported (azo pigments, quinacridone) and unreported (carbon black, phtalocyanine) putative organic sensitizer compounds, and also defined the phase in which Ti was engaged. To the best of the authors' knowledge, this paper reports the largest cohort of skin hypersensitivity reactions analyzed by multiple complementary techniques. With almost half the patients presenting skin reaction on black tattoo, the study suggests that black modern inks should also be considered to provoke skin reactions, probably because of the common association of carbon black with potential allergenic metals within these inks. Analysis of more skin reactions to tattoos is needed to identify the relevant chemical compounds and help render tattoo ink composition safer.
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Affiliation(s)
- Hester Colboc
- Sorbonne Université, Hôpital Rothschild, Service de Gériatrie-Plaies et Cicatrisation, Paris, France
- Sorbonne Université, UPMC Paris 06, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S 1155, F-75020 Paris, France
| | - Dominique Bazin
- Institut de Chimie Physique, Université Paris-Saclay, Orsay, France
| | - Solenn Reguer
- DiffAbs Beamline, Synchrotron SOLEIL, L’Orme des Merisiers, Départementale 128, 91190 Saint-Aubin, France
| | - Ivan T. Lucas
- Sorbonne Université, CNRS, Laboratoire Lise UMR 8235, Paris, France
| | - Philippe Moguelet
- Sorbonne Université, Hôpital Tenon, Anatomie et Cytologie Pathologiques, Paris, France
| | | | - Chantal Jouanneau
- Sorbonne Université, UPMC Paris 06, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S 1155, F-75020 Paris, France
| | - Angèle Soria
- Sorbonne Université, Hôpital Tenon, Service de Dermatologie-Allergologie, Paris, France
| | - François Chasset
- Sorbonne Université, Hôpital Tenon, Service de Dermatologie-Allergologie, Paris, France
| | - Emmanuelle Amsler
- Sorbonne Université, Hôpital Tenon, Service de Dermatologie-Allergologie, Paris, France
| | - Catherine Pecquet
- Sorbonne Université, Hôpital Tenon, Service de Dermatologie-Allergologie, Paris, France
| | - Sélim Aractingi
- Université de Paris, Hôpital Cochin, Service de Dermatologie, Paris, France
| | | | - Lydia Deschamps
- Université de Paris, Hôpital Bichat, Service d’Anatomie et Cytologie Pathologique, Paris, France
| | - Vincent Descamps
- Université de Paris, Hôpital Bichat, Service de Dermatologie, Paris, France
| | - Nicolas Kluger
- Université de Paris, Hôpital Bichat, Service de Dermatologie, Paris, France
- Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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5
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Tomita S, Mori K, Yamazaki H. A Survey on the Safety of and Patient Satisfaction After Nipple-Areola Tattooing. Aesthetic Plast Surg 2021; 45:968-974. [PMID: 33112992 DOI: 10.1007/s00266-020-02018-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nipple-areolar tattooing is well accepted as part of breast reconstruction, but the clinical data on its safety and patient satisfaction after the procedure are insufficient. We aimed to evaluate the complications of and patient satisfaction after nipple-areola tattooing in Japanese post-mastectomy breast reconstruction patients. METHODS Patients who visited our center after undergoing nipple-areola tattooing from January 2017 to March 2020 were given an unmarked questionnaire with questions about complications related to their nipple-areola tattoo. Patients' registered their subjective evaluation responses regarding nipple-areola appearance using visual analog scale and that regarding overall satisfaction using 5-point Likert scale and free-text responses. Patients who were followed up within 6 months after tattooing or those with incomplete data were excluded. RESULTS Sixty-two patients (average age: 49.7 ± 9.8 years), with an average post-tattooing period of 21.2 ± 10.5 months, were included. No patient had infections or allergic reactions. The average VAS score for nipple-areola appearance was high (8.5), and 59 patients (95.3%) answered that they were satisfied. In the free-text patient responses, 25 patients answered that they now felt comfortable going to the hot spring or taking a bath with their children, and 19 patients reported improved mental health after the procedure. CONCLUSION Post-breast reconstruction nipple-areola tattooing with sterilized inorganic pigments could achieve high esthetics and patient satisfaction, without serious complications. It is recommended for Japanese individuals with a culture of visiting hot springs and public baths. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each submission to which evidence-based medicine rankings are applicable. This excludes review articles, book reviews, and manuscripts that concern basic science, animal studies, cadaver studies, and experimental studies. For a full description of these evidence-based medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266 .
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Affiliation(s)
- Shoichi Tomita
- Department of Plastic and Reconstructive Surgery, Tokyo Shinjuku Medical Center, Japan Community Health Care Organization, Tokyo, Japan.
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Tomita S, Mori K, Yamazaki H, Mori K. Complications of permanent makeup procedures for the eyebrow and eyeline. Medicine (Baltimore) 2021; 100:e25755. [PMID: 33950961 PMCID: PMC8104296 DOI: 10.1097/md.0000000000025755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/08/2021] [Indexed: 01/04/2023] Open
Abstract
Japan is one of the few countries that consider the application of permanent makeup a medical procedure, and only doctors and nurses are allowed to perform this procedure. Studies on the safety and esthetic outcomes of permanent makeup procedures are not available, although there are studies that report allergies and other complications associated with permanent makeup. Thus, we aimed to study the complications and esthetic outcomes of permanent makeup.We surveyed clients who underwent permanent eyebrow or eyeline makeup procedures at the Shibuya Mori Clinic between November 2016 and March 2020 using a paper-based questionnaire. The permanent makeup procedures involved inorganic pigments, such as iron oxide and titanium dioxide. The questionnaire consisted of 2 parts: the first part asked whether the clients had experienced persistent redness, itching, swelling, infection, or any other complications (multiple answers possible). The second part used a 5-point Likert scale to rate the clients' satisfaction with the color, shape, and overall appearance of their permanent makeup. We retrospectively studied the clients' responses to survey items.A total of 1352 clients participated in the survey. The median period between the procedure and survey response was 15 days. Overall, complications were reported in 12.1% of cases. The most common complication for each type of procedure was itching for eyebrow procedures (8.2%) and swelling for eyeline procedures (13.2%). Infections were reported in 3 cases (0.2%). None of the post-procedure symptoms persisted until the time of this study. The Likert scale measurements revealed that 89.6% of subjects were satisfied with the aesthetic outcome of their permanent makeup procedure(s).We believe that all symptoms observed in this study were due to needle insertion. No allergies were observed, and the infection rate was quite low (0.2%). Thus, our results suggest that permanent makeup procedures are safe and are associated with high client satisfaction. We must note that the appropriate environment, equipment, and techniques are important prerequisites.
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Affiliation(s)
- Shoichi Tomita
- Department of Plastic and Reconstructive Surgery, Japan Community Health Care Organization, Tokyo Shinjuku Medical Center
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7
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[Reluctance determinants of dermatologists about tattooing in patients with psoriasis. An international study]. Ann Dermatol Venereol 2020; 147:809-817. [PMID: 32896422 DOI: 10.1016/j.annder.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tattoos are an increasingly common phenomenon, with a prevalence of around 10-30 % of the population in Western countries. The "Tatou" project assessed the risks of tattooing for patients with psoriasis. The first part revealed strong opposition to tattoos in these patients on the part of dermatologists, despite fewer than a quarter of them having any personal experience of complications. The second part showed a very low rate (6.6 %) of local complications on tattoos in these patients as well as absence of severe complications. These observations led us to assess the reasons for reluctance about tattoos in the 468 dermatologists involved in the first part of the "Tatou" project. PATIENTS AND METHODS We conducted a cross-sectional international study in France, Finland and Italy to evaluate the experience and opinions of dermatologists regarding tattoos in psoriasis patients via an anonymous questionnaire. We then examined the stated reasons for opposition to tattoos in order to establish the profiles of "tattoo-sceptical" dermatologists with regard to 4 different situations: active psoriasis, quiescent psoriasis, treatment with topical steroids and biotherapies. RESULTS The opinion of dermatologists regarding tattoos was generally unfavourable (3.5±2.8/10), in particular, via multivariate analysis, among older dermatologists (P=0.01), dermatologists in private practice (P=0.04), and non-tattooed dermatologists (P<0.0001). In multivariate analysis, the main parameter affecting the position of practitioner with regard to tattoos was their personal opinion of tattoos (P<0.0001), regardless of disease activity or type of treatment. Italian, Finnish and female dermatologists exhibited greater reluctance but in a less consistent fashion. CONCLUSION This analysis suggests a lack of objectivity among dermatologists opposed to tattoos probably stemming more from a poor opinion of this practice than from any fear of complications in their psoriatic patients.
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Géraut C. Complications des tatouages : informations récentes justifiant la prise de mesures urgentes. BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2020; 204:604-606. [PMID: 32296243 PMCID: PMC7158815 DOI: 10.1016/j.banm.2020.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Les tatouages cutanés sont pratiqués depuis fort longtemps mais leur toxicité reste peu connue du grand public qui a de plus en plus recours à ces techniques sans être informé des risques encourus, infectieux, allergiques, dermatologiques, toxiques systémiques et même ophtalmologiques. Cette situation est aggravée par la mode des tatouages « corps entier ». Cette séance dédiée est une mise au point des risques encourus liés aux tatouages.
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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
Tattoos are more and more frequent and their surface is increasing. They are also becoming more and more colorful. Complications are frequent and induce a wide variety of clinical and histological pictures. The inks, the composition of which is not always known, contain many pigments which degradation products can lead to chronic allergies. The long-term effects of the presence of carcinogenic products and nanoparticles justify the carrying out of prospective studies. The public should be made aware of these complications and of the difficulties of tattoo removal.
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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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Grodner C, Beauchet A, Fougerousse A, Quiles‐Tsimaratos N, Perrot J, Barthelemy H, Parier J, Maccari F, Beneton N, Bouilly‐Auvray D, Ruer‐Mulard M, Boulard C, Jacobzone C, Thomas‐Beaulieu D, Pourchot D, Méry‐Bossard L, Chaby G, Girard C, Duval‐Modeste A, Vermersch‐Langlin A, Delaunay J, Marc S, Kemula M, Steff M, Bilan P, Liégeon A, Aubert H, Solyga B, Kluger N, Mahé E. Tattoo complications in treated and non‐treated psoriatic patients. J Eur Acad Dermatol Venereol 2020; 34:888-896. [DOI: 10.1111/jdv.15975] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 09/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- C. Grodner
- Dermatology Department Hôpital Victor Dupouy Argenteuil France
| | - A. Beauchet
- Public Health Department Hôpital Ambroise Paré Boulogne‐Billancourt France
| | - A.‐C. Fougerousse
- Dermatology Department Hôpital d'Instruction des Armées Bégin Saint Mandé France
| | | | - J.‐L. Perrot
- Dermatology Department CHU Saint‐Etienne Saint‐Etienne France
| | - H. Barthelemy
- Dermatology Department Centre Hospitalier d'Auxerre Auxerre France
| | - J. Parier
- Private Office La Varenne St Hilaire France
| | - F. Maccari
- Private Office La Varenne St Hilaire France
| | - N. Beneton
- Dermatology Department Centre Hospitalier du Mans Le Mans France
| | - D. Bouilly‐Auvray
- Dermatology Department Centre Hospitalier Universitaire de Dijon Dijon France
| | | | - C. Boulard
- Dermatology Department Hôpital Jacques Monod Le Havre Cedex France
| | - C. Jacobzone
- Dermatology Department Centre Hospitalier de Lorient Lorient France
| | - D. Thomas‐Beaulieu
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - D. Pourchot
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - L. Méry‐Bossard
- Dermatology Department Centre Hospitalier Intercommunal de Poissy/Saint‐Germain‐en‐Laye Saint‐Germain‐en‐Laye France
| | - G. Chaby
- Dermatology Department Hôpital Sud Amiens France
| | - C. Girard
- Dermatology Department Centre Hospitalier Universitaire de Montpellier Montpellier France
| | - A.‐B. Duval‐Modeste
- Dermatology Department Centre Hospitalier Universitaire Charles‐Nicolle Rouen France
| | | | | | - S. Marc
- Dermatology Department Hôpital François Quesnay Mantes La Jolie France
| | | | - M. Steff
- Dermatology Department Hôpital Intercommunal Robert‐Ballanger Aulnay‐sous‐Bois France
| | - P. Bilan
- Dermatology Department Hôpital Intercommunal Robert‐Ballanger Aulnay‐sous‐Bois France
| | - A.‐L. Liégeon
- Dermatology Department Hôpital de Valence Valence France
| | - H. Aubert
- Dermatology Department Centre Hospitalier Universitaire de Nantes Nantes France
| | - B. Solyga
- Private Office Fontenay‐sous‐Bois France
| | - N. Kluger
- Dermatology Department, Allergology, and Venereology University of Helsinki and Helsinki University Central Hospital Helsinki Finland
- Dermatology Department Tattoo Consultation Centre Hospitalier Universitaire Bichat‐Claude Bernard Assistance Publique‐Hôpitaux de Paris Paris France
| | - E. Mahé
- Dermatology Department Hôpital Victor Dupouy Argenteuil France
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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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Gonzalez CD, Rundle CW, Pona A, Walkosz BJ, Dellavalle RP. Ultraviolet radiation may cause premature fading of colored tattoos. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 36:73-74. [PMID: 31461178 DOI: 10.1111/phpp.12509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/21/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Cristian D. Gonzalez
- Department of Dermatology University of Colorado School of Medicine Aurora CO USA
| | - Chandler W. Rundle
- Department of Dermatology University of Colorado School of Medicine Aurora CO USA
| | - Adrian Pona
- Department of Dermatology University of Colorado School of Medicine Aurora CO USA
| | | | - Robert P. Dellavalle
- Department of Dermatology University of Colorado School of Medicine Aurora CO USA
- US Department of Veterans Affairs Rocky Mountain Regional VA Medical Center Dermatology Service Aurora CO USA
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Rogers E, Irwin C, McCartney D, Cox GR, Desbrow B. Tattoos do not affect exercise-induced localised sweat rate or sodium concentration. J Sci Med Sport 2019; 22:1249-1253. [PMID: 31235387 DOI: 10.1016/j.jsams.2019.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/06/2019] [Accepted: 06/13/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Skin tattoos have been shown to reduce localised sweat rate and increase sweat sodium concentration ([Na+]) when sweating is artificially stimulated. This study investigated whether similar responses are observed with exercise-induced sweating. DESIGN Unblinded, within-participant control, single trial. METHODS Twenty-two healthy individuals (25.1±4.8 y (Mean±SD), 14 males) with a unilateral tattoo ≥11.4cm2 in size, ≥2 months in age, and shaded ≥50% participated in this investigation. Participants undertook 20min of intermittent cycling (4×5min intervals) on a stationary ergometer in a controlled environment (24.6±1.1°C; 64±6% RH). Resultant sweat was collected into absorbent patches applied at two pairs of contralateral skin sites (pair 1: Tattoo vs. Non-Tattoo; pair 2: Control 1 vs. Control 2 (both non-tattooed)), for determination of sweat rate and sweat [Na+]. Paired samples t-tests were used to determine differences between contralateral sites. RESULTS Tattoo vs. Non-Tattoo: Neither sweat rate (Mean±SD: 0.92±0.37 vs. 0.94±0.43mg·cm-2·min-1, respectively; p=0.693) nor sweat [Na+] (Median(IQR): 37(32-52) vs. 37(31-45) mM·L-1, respectively; p=0.827) differed. Control 1 vs. Control 2: Neither sweat rate (Mean±SD: 1.19±0.53 vs. 1.19±0.53mg·cm-2·min-1, respectively; p=0.917) nor sweat [Na+] (Median(IQR): 29(26-41) vs. 31(25-43)mM·L-1, respectively; p=0.147) differed. The non-significant differences for sweat rate and [Na+] between Tattoo vs. Non-Tattoo were inside the range of the within participant variability (sweat rate CVi=5.4%; sweat [Na+] CVi=4.4%). CONCLUSIONS Skin tattoos do not appear to alter the rate or [Na+] of exercise-induced sweating. The influence of skin tattoos on localised sweat responses may have previously been over-estimated.
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Affiliation(s)
- Ethan Rogers
- School of Allied Health Sciences, Griffith University, Australia
| | | | - Danielle McCartney
- School of Allied Health Sciences, Griffith University, Australia; Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Australia
| | - Gregory R Cox
- Faculty of Health Sciences and Medicine, Bond University, Australia
| | - Ben Desbrow
- School of Allied Health Sciences, Griffith University, Australia.
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Kluger N. Tattooing and psoriasis: demographics, motivations and attitudes, complications, and impact on body image in a series of 90 Finnish patients. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [PMID: 28632882 DOI: 10.15570/actaapa.2017.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Koebner phenomenon (KP) affects up to a third of patients with psoriasis and can occur on tattoos. Little is known about the extent of tattooing and its consequences among psoriatic patients. A survey was conducted to determine the demographics, motivations and attitudes towards tattoos, and complications among tattooed patients with psoriasis, and the impact on their body image. METHODS Ninety Finnish patients completed an internet self-reported questionnaire in June 2016. RESULTS Fifty-two percent (48/90) had one tattoo or more (mean number of three tattoos, range 1-20). They were younger than non-tattooed patients (p = 0.001). Of these, 27.6% experienced a KP on their tattoos from 1 week to 15 to 20 years after tattooing. Among those, 30% reported an acute flare-up of psoriasis within the first weeks after tattooing. They were more likely to have a history of KP. Less than 7% reported a psoriasis flare-up on another part of the body after tattooing. Eighty-two percent stated that their tattoo(s) had a positive effect on their body image. CONCLUSION KP on tattoos is not particularly frequent in patients with psoriasis. Tattooing has a bolstering effect on body image and should not be a contraindication. However, patients need proper counseling before receiving tattoos.
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Affiliation(s)
- Nicolas Kluger
- Departments of Dermatology, Allergology, and Venereology, Helsinki University Central Hospital, Helsinki, Finland
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15
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Dieckmann R, Boone I, Brockmann SO, Hammerl JA, Kolb-Mäurer A, Goebeler M, Luch A, Al Dahouk S. The Risk of Bacterial Infection After Tattooing. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 113:665-671. [PMID: 27788747 DOI: 10.3238/arztebl.2016.0665] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/02/2015] [Accepted: 06/08/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tattooing is a globally growing trend. Overall prevalence among adults in industrialized countries is around 10-20%. Given the high and increasing numbers of tattooed people worldwide, medical and public health implications emerging from tattooing trends require greater attention not only by the public, but also by medical professionals and health policy makers. METHODS We performed a systematic review of the literature on tattooassociated bacterial infections and bacterial contamination of tattoo inks. Furthermore, we surveyed tattoo inks sampled during an international tattoo convention in Germany to study their microbial status. RESULTS Our systematic review identified 67 cases published between 1984 and 2015, mainly documenting serious bacterial infectious complications after intradermal deposition of tattoo inks. Both local skin infections (e.g. abscesses, necrotizing fasciitis) and systemic infections (e.g. endocarditis, septic shock) were reported. Published bacteriological surveys showed that opened as well as unopened tattoo ink bottles frequently contained clinically relevant levels of bacteria indicating that the manufactured tattoo product itself may be a source of infection. In our bacteriological survey, two of 39 colorants were contaminated with aerobic mesophilic bacteria. CONCLUSION Inappropriate hygiene measures in tattoo parlors and non-medical wound care are major risk factors for tattoo-related infections. In addition, facultative pathogenic bacterial species can be isolated from tattoo inks in use, which may pose a serious health risk.
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Affiliation(s)
- Ralf Dieckmann
- German Federal Institute for Risk Assessment (BfR), Department of Biological Safety, Berlin, Regional Public Health Office, Department for Infection Control, Reutlingen, University Hospital Würzburg, Department of Dermatology, Venereology and Allergology, Würzburg, German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Berlin, RWTH Aachen University Hospital, Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), Aachen
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Bäumler W. Tattoos and Their Potential Health Consequences. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 113:663-664. [PMID: 27788746 DOI: 10.3238/arztebl.2016.0663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
A 31-year-old man developed a fast-growing tumor on the right upper arm within a black tattoo, which could be classified histologically as pilomatrixoma. While the age of the patient and the rapid growth of the tumor cannot be regarded as typical findings of pilomatrixomas, the localization on the upper arm is one of their predilection points. Despite the wide spread use of tattoos in the last few decades, tumor development in tattooed skin is rarely reported. It is still controversial whether the ingredients of the tattoo agents can be responsible for tumor induction.
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Affiliation(s)
- G Wagner
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland.
| | - V Meyer
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland
| | - M M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland
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Ondruschka B, Ramsthaler F, Birngruber CG. Forensische Bedeutung von Körpermodifikationen. Rechtsmedizin (Berl) 2017. [DOI: 10.1007/s00194-017-0183-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chokoeva AA, Tchernev G. Wolf's Panniculitis. Open Access Maced J Med Sci 2017; 5:397-398. [PMID: 28698763 PMCID: PMC5503743 DOI: 10.3889/oamjms.2017.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/27/2017] [Accepted: 05/16/2017] [Indexed: 11/17/2022] Open
Abstract
A 28-year-old male patient, presented with a one-week history of pain and itching on the skin of the left upper leg. Erythematous indurated, warm and painful on palpation, subcutaneous plaques and nodules were clinically observed, affecting the skin of the left upper leg, within a recent black-wolf tattoo. The diagnosis of traumatic panniculitis with superposed bacterial infection, provoked by a wolf tattoo was made. The patient underwent 7-days systemic antibiotic treatment regimen and topical application of iodine povidone unguent under occlusion for 7 days. Significant alleviation of the subjective complaints was achieved within the first week, with a total clinical resolution of the symptoms. The role of the procedure as a source of trauma for subcutaneous inflammation (traumatic panniculitis) and the contamination of the equipment or the staff (infective panniculitis) in simultaneously triggering of the pathogenetic chain of the reported Wolf’s panniculitis could be present.
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Affiliation(s)
| | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
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Body piercing and tattooing among French patients with bleeding disorders. Presse Med 2017; 46:538-540. [DOI: 10.1016/j.lpm.2017.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/07/2017] [Accepted: 03/13/2017] [Indexed: 11/23/2022] Open
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Kluger N. The place and willingness of professional tattooists for melanoma screening. Int J Dermatol 2017; 56:e59-e61. [PMID: 28083926 DOI: 10.1111/ijd.13525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 10/25/2016] [Accepted: 11/11/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, Allergology and Venereology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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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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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. Pregnancies in tattooed female tattooists: an observational study. Eur J Obstet Gynecol Reprod Biol 2015; 189:112-3. [PMID: 25857805 DOI: 10.1016/j.ejogrb.2015.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 03/10/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Nicolas Kluger
- University of Helsinki and Helsinki University Central: Dermatology, Meilahdentie 2, P.O. Box 160, FI-00029 HUS, Finland.
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