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Nielsen C, Jerkeman M, Jöud AS. Tattoos as a risk factor for malignant lymphoma: a population-based case-control study. EClinicalMedicine 2024; 72:102649. [PMID: 38827888 PMCID: PMC11141277 DOI: 10.1016/j.eclinm.2024.102649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
Background The popularity of tattoos has increased dramatically over the last few decades. Tattoo ink often contains carcinogenic chemicals, e.g., primary aromatic amines, polycyclic aromatic hydrocarbons, and metals. The tattooing process invokes an immunologic response that causes translocation of tattoo ink from the injection site. Deposition of tattoo pigment in lymph nodes has been confirmed but the long-term health effects remain unexplored. We used Swedish National Authority Registers with full population coverage to investigate the association between tattoo exposure and overall malignant lymphoma as well as lymphoma subtypes. Methods We performed a case-control study where we identified all incident cases of malignant lymphoma diagnosed between 2007 and 2017 in individuals aged 20-60 years in the Swedish National Cancer Register. Three random age- and sex-matched controls per case were sampled from the Total Population Register using incidence density sampling. We assessed exposure through a questionnaire in 2021, and data on potential confounders were retrieved from registers. We used multivariable logistic regression to estimate the incidence rate ratio (IRR) of malignant lymphoma in tattooed individuals. Findings The study population consisted of 11,905 individuals, and the response rate was 54% among cases (n = 1398) and 47% among controls (n = 4193). The tattoo prevalence was 21% among cases and 18% among controls. Tattooed individuals had a higher adjusted risk of overall lymphoma (IRR = 1.21; 95% CI 0.99-1.48). The risk of lymphoma was highest in individuals with less than two years between their first tattoo and the index year (IRR = 1.81; 95% CI 1.03-3.20). The risk decreased with intermediate exposure duration (three to ten years) but increased again in individuals who received their first tattoo ≥11 years before the index year (IRR = 1.19; 95% CI 0.94-1.50). We found no evidence of increasing risk with a larger area of total tattooed body surface. The risk associated with tattoo exposure seemed to be highest for diffuse large B-cell lymphoma (IRR 1.30; 95% CI 0.99-1.71) and follicular lymphoma (IRR 1.29; 95% CI 0.92-1.82). Interpretation Our findings suggested that tattoo exposure was associated with an increased risk of malignant lymphoma. More epidemiologic research is urgently needed to establish causality. Funding The Swedish Research Council for Health, Working Life and Welfare.
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Affiliation(s)
- Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Mats Jerkeman
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Anna Saxne Jöud
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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2
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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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3
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Kluger N, Badawi A, Laubach HJ, Wolkerstorfer A, Cartier H. Laser tattoo removal and risks of cancer: A joint statement of the EADV tattoo and body art task force, European Society for Lasers and Energy-Based Devices (ESLD) and la Société Française des lasers en Dermatologie. J Eur Acad Dermatol Venereol 2023; 37:e1354-e1355. [PMID: 37441733 DOI: 10.1111/jdv.19332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, Allergology, and Venereology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- "Tattoo" Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- EADV Task Force on Tattoos and Body Art, Lugano, Switzerland
| | - Ashraf Badawi
- European Society for Lasers and Energy-Based Devices (ESLD), Paris, France
- Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Hans-Joachim Laubach
- European Society for Lasers and Energy-Based Devices (ESLD), Paris, France
- Department of Dermatology and Venereology, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Albert Wolkerstorfer
- European Society for Lasers and Energy-Based Devices (ESLD), Paris, France
- Department of Dermatology, Amsterdam UMC, The Netherlands
| | - Hugues Cartier
- EADV Task Force on Tattoos and Body Art, Lugano, Switzerland
- Centre Médical Saint-Jean, Arras, France
- Société Française des Lasers en Dermatologie, Société Française de Dermatologie, Paris, France
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4
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Foerster M, Dufour L, Bäumler W, Schreiver I, Goldberg M, Zins M, Ezzedine K, Schüz J. Development and Validation of the Epidemiological Tattoo Assessment Tool to Assess Ink Exposure and Related Factors in Tattooed Populations for Medical Research: Cross-sectional Validation Study. JMIR Form Res 2023; 7:e42158. [PMID: 36630184 PMCID: PMC9878366 DOI: 10.2196/42158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/03/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Tattooing, whose popularity is growing worldwide, is an invasive body art that involves the injection of chemical mixtures, the tattoo ink, into the upper layer of the dermis. Although these inks may contain environmental toxins, including known human carcinogens, their long-term health effects are poorly studied. To conduct the urgently required epidemiological studies on tattoos and their long-term health effects, a validated method for assessing the complex tattoo exposure is needed. OBJECTIVE We aimed to develop and validate the Epidemiological Tattoo Assessment Tool (EpiTAT), a questionnaire to self-assess tattoo ink exposure in tattooed populations suitable for application in large epidemiological cohort studies. METHODS One of 3 preliminary versions of the EpiTAT using one of the alternative tattoo measurement units hand surface, credit card, or body schemes was randomly filled in by tattooed volunteers in Lyon, France. To identify the most suitable unit of tattoo self-assessment, a validation study was conducted with the selected respondents (N=97) to compare the self-assessments of tattoo surface, color, and coverage with validation measurements made by trained study personnel. Intraclass correlation, the Kendall rank correlation, and 2-tailed t tests were used to statistically compare tattoo size, color area, and tattoo coverage separately for each questionnaire version. Participants' opinions on the alternative measurement units were also considered in the overall evaluation. For quality control of the validation measures, digital surface analysis of 62 photographs of selected tattoos was performed using Fiji/ImageJ. RESULTS In general, the results revealed overestimation of self-assessed measures compared with validation measures (eg, mean tattooed body surface 1768, SD 1547, cm2 vs 930, SD 1047, cm2, respectively, for hand surface; P<.001) and validation measures compared with digital image analysis (mean individual tattoo surface 147, SD 303.9, cm2 vs 101, SD 154.7, cm2, respectively; P=.05). Although the measurement unit credit card yielded the most accurate measures for all variables of interest, it had a much lower completion rate (78/129, 60.5%) than hand surface (89/104, 85.6%) and body schemes (90/106, 84.9%). Hand surface measured total tattoo size more accurately than body schemes (absolute agreement intraclass correlation coefficient: 0.71 vs 0.64, respectively). CONCLUSIONS The final version of the EpiTAT contains 21 items and uses hand surface as a visual unit of measurement. Likert scales are used to assess color and coverage as a proportion of the total tattoo area. The overestimation of tattoo size by self-reporting merits further research to identify potential influential factors or predictive patterns that could be considered when calculating exposure.
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Affiliation(s)
- Milena Foerster
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organisation, Lyon, France
| | - Lucas Dufour
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organisation, Lyon, France
| | - Wolfgang Bäumler
- Department of Dermatology, University Hospital of Regensburg, Regensburg, Germany
| | - Ines Schreiver
- Dermatotoxicology Study Centre, Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Marcel Goldberg
- Population-based Cohorts Unit, INSERM UMS 11, Paris Saclay University, Paris, France
| | - Marie Zins
- Population-based Cohorts Unit, INSERM UMS 11, Paris Saclay University, Paris, France
| | - Khaled Ezzedine
- University Hospital Henri-Mondor, University Paris Est-Créteil, Créteil, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organisation, Lyon, France
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Devcic J, Dussol M, Collin-Faure V, Pérard J, Fenel D, Schoehn G, Carrière M, Rabilloud T, Dalzon B. Immediate and Sustained Effects of Cobalt and Zinc-Containing Pigments on Macrophages. Front Immunol 2022; 13:865239. [PMID: 35928812 PMCID: PMC9343594 DOI: 10.3389/fimmu.2022.865239] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Pigments are among the oldest nanoparticulate products known to mankind, and their use in tattoos is also very old. Nowadays, 25% of American people aged 18 to 50 are tattooed, which poses the question of the delayed effects of tattoos. In this article, we investigated three cobalt [Pigment Violet 14 (purple color)] or cobalt alloy pigments [Pigment Blue 28 (blue color), Pigment Green 14 (green color)], and one zinc pigment [Pigment White 4 (white color)] which constitute a wide range of colors found in tattoos. These pigments contain microparticles and a significant proportion of submicroparticles or nanoparticles (in either aggregate or free form). Because of the key role of macrophages in the scavenging of particulate materials, we tested the effects of cobalt- and zinc-based pigments on the J774A.1 macrophage cell line. In order to detect delayed effects, we compared two exposure schemes: acute exposure for 24 hours and an exposure for 24 hours followed by a 3-day post-exposure recovery period. The conjunction of these two schemes allowed for the investigation of the delayed or sustained effects of pigments. All pigments induced functional effects on macrophages, most of which were pigment-dependent. For example, Pigment Green 19, Pigment Blue 28, and Pigment White 4 showed a delayed alteration of the phagocytic capacity of cells. Moreover, all the pigments tested induced a slight but significant increase in tumor necrosis factor secretion. This effect, however, was transitory. Conversely, only Pigment Blue 28 induced both a short and sustained increase in interleukin 6 secretion. Results showed that in response to bacterial stimuli (LPS), the secretion of tumor necrosis factor and interleukin 6 declined after exposure to pigments followed by a recovery period. For chemoattractant cytokines (MCP-1 or MIP-1α), delayed effects were observed with a secretion decreased in presence of Pigment Blue 28 and Pigment violet 14, both with or without LPS stimuli. The pigments also induced persisting changes in some important macrophage membrane markers such as CD11b, an integrin contributing to cell adhesion and immunological tolerance. In conclusion, the pigments induced functional disorders in macrophages, which, in some cases, persist long after exposure, even at non-toxic doses.
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Affiliation(s)
- Julie Devcic
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Manon Dussol
- Université Grenoble-Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Recherche Interdisciplinaire de Grenoble (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE), Systèmes Moléculaires et nanoMatériaux pour l’Energie et la Santé (SyMMES), Chemistry Interface Biology for the Environment, Health and Toxicology (CIBEST), Grenoble, France
| | - Véronique Collin-Faure
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Julien Pérard
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Daphna Fenel
- Univ. Grenoble Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Biologie Structurale (IBS), Grenoble, France
| | - Guy Schoehn
- Univ. Grenoble Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Biologie Structurale (IBS), Grenoble, France
| | - Marie Carrière
- Université Grenoble-Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Recherche Interdisciplinaire de Grenoble (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE), Systèmes Moléculaires et nanoMatériaux pour l’Energie et la Santé (SyMMES), Chemistry Interface Biology for the Environment, Health and Toxicology (CIBEST), Grenoble, France
| | - Thierry Rabilloud
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
- *Correspondence: Thierry Rabilloud, ; Bastien Dalzon,
| | - Bastien Dalzon
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
- *Correspondence: Thierry Rabilloud, ; Bastien Dalzon,
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Sindoni A, Valeriani F, Gallè F, Liguori G, Romano Spica V, Vitali M, Protano C. Adverse effects related to tattoos in the community setting: a systematic review. J Epidemiol Community Health 2021; 75:1023-1028. [PMID: 34253557 DOI: 10.1136/jech-2021-216874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tattoos were historically associated with deviant behaviours or religious and other social purposes, but in the last decades, they have gained increasing popularity and have become a mainstream. The aim of this systematic review is to assess the literature evidence about decorative tattoos complications, considering both infective and non-infective risks. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following electronic bibliographic databases: PubMed, Scopus and Web of Science (science and social science citation index). RESULTS The literature search resulted in 6473 studies. A total of 207 full articles were considered potentially relevant and were reviewed independently by researchers. After full-text evaluation, 152 of 207 articles were excluded, as they did not meet selection criteria. The remaining 55 studies were included in the systematic review and their quality assessment was performed. Ten studies reported microbiological complications, 37 reported non-microbiological effects and eight reported either microbiological and non-microbiological complications. CONCLUSIONS Several well-known and uncommon risks are associated with tattooing and tattoo after-care. Public health authorities could take into account health education programmes for tattooists and customers in order to prevent health complications in people with tattoos. PROSPERO REGISTRATION NUMBER CRD42020177972.
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Affiliation(s)
- Alessandro Sindoni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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7
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Weiß KT, Schreiver I, Siewert K, Luch A, Haslböck B, Berneburg M, Bäumler W. Tattoos – mehr als nur kolorierte Haut? Auf der Suche nach Tattoo‐Allergenen. J Dtsch Dermatol Ges 2021; 19:657-671. [PMID: 33979044 DOI: 10.1111/ddg.14436_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Katharina T Weiß
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg
| | - Ines Schreiver
- Abteilung Chemikalien- und Produktsicherheit, Bundesinstitut für Risikobewertung (BfR), Berlin
| | - Katherina Siewert
- Abteilung Chemikalien- und Produktsicherheit, Bundesinstitut für Risikobewertung (BfR), Berlin
| | - Andreas Luch
- Abteilung Chemikalien- und Produktsicherheit, Bundesinstitut für Risikobewertung (BfR), Berlin
| | - Birgit Haslböck
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg
| | - Mark Berneburg
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg
| | - Wolfgang Bäumler
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg
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8
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Weiß KT, Schreiver I, Siewert K, Luch A, Haslböck B, Berneburg M, Bäumler W. Tattoos - more than just colored skin? Searching for tattoo allergens. J Dtsch Dermatol Ges 2021; 19:657-669. [PMID: 33955682 DOI: 10.1111/ddg.14436] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022]
Abstract
During tattooing, a high amount of ink is injected into the skin. Tattoo inks contain numerous substances such as the coloring pigments, impurities, solvents, emulsifiers, and preservatives. Black amorphous carbon particles (carbon black), white titanium dioxide, azo or polycyclic pigments create all varieties of color shades in the visible spectrum. Some ingredients of tattoo inks might be hazardous and allergenic chemicals of unknown potential. In Germany, about 20 % of the general population is tattooed and related adverse reactions are increasingly reported. Since tattoo needles inevitably harm the skin, microorganisms can enter the wound and may cause infections. Non-allergic inflammatory reactions (for example cutaneous granuloma and pseudolymphoma) as well as allergic reactions may emerge during or after wound healing. Especially with allergies occurring after weeks, months or years, it remains difficult to identify the specific ingredient(s) that trigger the reaction. This review summarizes possible adverse effects related to tattooing with a focus on the development of tattoo-mediated allergies. To date, relevant allergens were only identified in rare cases. Here we present established methods and discuss current experimental approaches to identify culprit allergens in tattoo inks - via testing of the patient and in vitro approaches.
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Affiliation(s)
- Katharina T Weiß
- Department of Dermatology and Allergology, University of Regensburg, Regensburg, Germany
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Katherina Siewert
- 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
| | - Birgit Haslböck
- Department of Dermatology and Allergology, University of Regensburg, Regensburg, Germany
| | - Mark Berneburg
- Department of Dermatology and Allergology, University of Regensburg, Regensburg, Germany
| | - Wolfgang Bäumler
- Department of Dermatology and Allergology, University of Regensburg, Regensburg, Germany
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9
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Abstract
Tattooing entails a high amount of tattoo colorants that is injected into skin. Tattoo colorants usually contain various substances of which the colouring component is the major ingredient that can be assigned to two different groups. Firstly, amorphous carbon particles (carbon black) are almost exclusively found in black tattoos. Secondly, tattooists use azo and polycyclic pigments to create nearly all colours of the visible spectrum. Due to their different but frequently complex chemistry, tattoo colorants usually contain various compounds like by-products and impurities which may exhibit health concerns. Professional tattooists inject that mixture into skin using the solid needles of tattoo machines. It is known that part of injected tattoo colorants is predominantly transported away from skin via lymphatic system. In addition to tattooing, exposure of tattooed skin to solar radiation or laser light may cause decomposition of pigment molecules leading to new and potential hazard chemical compounds. In light of the various hazard substances in the tattoo colorants and its decomposition products, tattooing might pose a health risk not only to skin but also to other organs of humans.
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10
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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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11
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Ju HJ, Eun SH, Lee HN, Lee JH, Kim GM, Bae JM. Micropigmentation for vitiligo on light to moderately colored skin: Updated evidence from a clinical and animal study. J Dermatol 2020; 47:464-469. [PMID: 32124487 DOI: 10.1111/1346-8138.15282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 02/03/2020] [Indexed: 12/12/2022]
Abstract
Micropigmentation, also termed medical tattooing, can be a useful alternative treatment for patients with vitiligo who are resistant to conventional treatments. To assess the benefits and risks of micropigmentation in the treatment of refractory vitiligo, 25 lesions of 14 patients with vitiligo (Fitzpatrick skin types III and IV) were subjected to micropigmentation using an electric tattooing machine between December 2018 and March 2019. The procedure was repeated until satisfactory results were obtained. Treatment response was assessed by color matching of the treated lesion and surrounding skin using a 4-point scale (poor, fair, good and excellent). Excellent color matching was achieved in 80% (20/25) of cases after a median of three (range, 1-5) treatment sessions. Procedure-associated pain was considerable, but no anesthetic injection was needed. Immediate erythema and swelling were noticed after each procedure, but resolved within a few days. Overall, the treatment was tolerable. This study was limited by a small sample, no control group and a short follow-up period. This study revealed that micropigmentation was beneficial for patients with refractory vitiligo who had light to moderately colored skin. Pigment selection, implantation depth and selection of body parts amenable to treatment were critical.
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Affiliation(s)
- Hyun Jeong Ju
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Hye Eun
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Han Na Lee
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hae Lee
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gyong Moon Kim
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Min Bae
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Giulbudagian M, Schreiver I, Singh AV, Laux P, Luch A. Safety of tattoos and permanent make-up: a regulatory view. Arch Toxicol 2020; 94:357-369. [DOI: 10.1007/s00204-020-02655-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/29/2020] [Indexed: 12/19/2022]
Abstract
AbstractThe continuous increase in the popularity of tattoos and permanent make-up (PMU) has led to substantial changes in their societal perception. Besides a better understanding of pathological conditions associated with the injection of highly diverse substances into subepidermal layers of the skin, their regulation has occupied regulatory bodies around the globe. In that sense, current regulatory progress in the European Union is an exemplary initiative for improving the safety of tattooing. On one hand, the compilation of market surveillance data has provided knowledge on hazardous substances present in tattoo inks. On the other hand, clinical data gathered from patients enabled correlation of adverse reactions with certain substances. Nevertheless, the assessment of risks remains a challenge due to knowledge gaps on the biokinetics of highly complex inks and their degradation products. This review article examines the strategies for regulating substances in tattoo inks and PMU in light of their potential future restriction in the frame of the REACH regulation. Substance categories are discussed in terms of their risk assessment and proposed concentration limits.
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13
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Serup J, Hutton Carlsen K, Dommershausen N, Sepehri M, Hesse B, Seim C, Luch A, Schreiver I. Identification of pigments related to allergic tattoo reactions in 104 human skin biopsies. Contact Dermatitis 2019; 82:73-82. [PMID: 31626330 PMCID: PMC6973263 DOI: 10.1111/cod.13423] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/08/2019] [Accepted: 10/17/2019] [Indexed: 12/13/2022]
Abstract
Background Red tattoos are prone to allergic reactions. The identity of the allergen(s) is mostly unknown. Objectives Chemical analysis of human skin biopsies from chronic allergic reactions in red tattoos to identify culprit pigment(s) and metals. Material and methods One hundred four dermatome biopsies were analyzed by matrix‐assisted laser desorption/ionization tandem mass spectrometry (MALDI‐MS/MS) for identification of commonly used organic pigments. Metal concentrations were assessed by inductively coupled plasma (ICP)‐MS and x‐ray fluorescence (XRF). Fourteen patients had cross‐reactions in other red tattoos. Results In total, the identified pigments were mainly azo Pigment Red (P.R.) 22 (35%), P.R. 210 (24%), P.R. 170 (12%), P.R. 5 (0.9%), P.R. 112 (0.9%), and Pigment Orange (P.O.) 13 (11%). P.R. 122 (0.9%) and Pigment Violet (P.V.) 23 (8%) were also common. P.R. 22, P.R. 170, and P.R. 210 also dominated in patients with cross‐reactions. In 22% of the biopsies, no red pigment was detected. Element analysis indicated the presence of the sensitizers nickel and chromium. Conclusions P.R. 22, P.R. 170, and P.R. 210 were identified as the prevailing pigments behind chronic allergic reactions in red tattoos. The epitope causing the reaction might be a pigment‐degradation product. Metal contamination may derive from different sources, and its role in red tattoo allergy cannot be ascertained.
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Affiliation(s)
- Jørgen Serup
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark
| | - Katrina Hutton Carlsen
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark
| | - Nils Dommershausen
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Mitra Sepehri
- Department of Plastic and Reconstructive Surgery, Herlev University Hospital, Herlev, Denmark
| | - Bernhard Hesse
- The European Synchrotron (ESRF), Grenoble Cedex 9, France.,Xploraytion GmbH, Berlin, Germany
| | - Christian Seim
- Xploraytion GmbH, Berlin, Germany.,Institute for Optics and Atomic Physics, Technische Universität Berlin, Berlin, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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14
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Rubio L, Guerra E, Garcia-Jares C, Lores M. Body-decorating products: Ingredients of permanent and temporary tattoos from analytical and european regulatory perspectives. Anal Chim Acta 2019; 1079:59-72. [DOI: 10.1016/j.aca.2019.06.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/26/2022]
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15
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Niederer M, Hauri U, Kroll L, Hohl C. Identification of organic pigments in tattoo inks and permanent make-up using laser desorption ionisation mass spectrometry. F1000Res 2018; 6:2034. [PMID: 29259773 DOI: 10.12688/f1000research.13035.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2017] [Indexed: 11/20/2022] Open
Abstract
Nowadays, about 12% of the European and 20% of the US population are tattooed. Rising concerns regarding consumer safety, led to legal restrictions on tattoo and permanent make-up (PMU) inks. Restrictions also include bans on certain colourants. Both ink types use organic pigments for colour-giving, plus inorganic pigments for white and black and colour tones. Pigments are only sparingly soluble in common solvents and occur as suspended particles in the ink matrix. Their detection and identification therefore pose a major challenge for laboratories involved in monitoring the legal compliance of tattoo inks and PMU. We overcame this challenge by developing a direct laser desorption ionisation time-of-flight mass spectrometry method, which included an easy sample clean up. The method proved to be capable of detecting and identifying organic pigments in almost all of the tested ink samples. Method validation and routine deployment during market surveys showed the method to be fit for purpose. Pigment screening of 396 tattoo inks and 55 PMU taken from the Swiss market between 2009 and 2017 lead to the following conclusions: Pigment variety is much greater in tattoo inks (18) than in PMU (10); four prohibited pigments (Pigment Green 7, Pigment Red 122, Pigment Violet 19 and 23) were found in both ink types; for PMU, these four pigments made up 12% of the pigment findings, compared to 32% for tattoo inks. Therefore, legal compliance of PMU was at a higher level. A comparison of pigments found with those declared on tattoo ink labels clearly showed that banned pigments are rarely declared, but rather masked by listing non present legal pigments and label forging; therefore, highlighting the urgency of widespread market controls.
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Affiliation(s)
| | - Urs Hauri
- State Laboratory Basel-City, Basel, 4056, Switzerland
| | - Lydia Kroll
- State Laboratory Basel-City, Basel, 4056, Switzerland
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16
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Niederer M, Hauri U, Kroll L, Hohl C. Identification of organic pigments in tattoo inks and permanent make-up using laser desorption ionisation mass spectrometry. F1000Res 2017; 6:2034. [PMID: 29259773 PMCID: PMC5728192 DOI: 10.12688/f1000research.13035.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/20/2022] Open
Abstract
Nowadays, about 12% of the European and 20% of the US population are tattooed. Rising concerns regarding consumer safety, led to legal restrictions on tattoo and permanent make-up (PMU) inks. Restrictions also include bans on certain colourants. Both ink types use organic pigments for colour-giving, plus inorganic pigments for white and black and colour tones. Pigments are only sparingly soluble in common solvents and occur as suspended particles in the ink matrix. Their detection and identification therefore pose a major challenge for laboratories involved in monitoring the legal compliance of tattoo inks and PMU. We overcame this challenge by developing a direct laser desorption ionisation time-of-flight mass spectrometry method, which included an easy sample clean up. The method proved to be capable of detecting and identifying organic pigments in almost all of the tested ink samples. Method validation and routine deployment during market surveys showed the method to be fit for purpose. Pigment screening of 396 tattoo inks and 55 PMU taken from the Swiss market between 2009 and 2017 lead to the following conclusions: Pigment variety is much greater in tattoo inks (18) than in PMU (10); four prohibited pigments (Pigment Green 7, Pigment Red 122, Pigment Violet 19 and 23) were found in both ink types; for PMU, these four pigments made up 12% of the pigment findings, compared to 32% for tattoo inks. Therefore, legal compliance of PMU was at a higher level. A comparison of pigments found with those declared on tattoo ink labels clearly showed that banned pigments are rarely declared, but rather masked by listing non present legal pigments and label forging; therefore, highlighting the urgency of widespread market controls.
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Affiliation(s)
| | - Urs Hauri
- State Laboratory Basel-City, Basel, 4056, Switzerland
| | - Lydia Kroll
- State Laboratory Basel-City, Basel, 4056, Switzerland
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17
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Ganguly D, Jain CK, Santra RC, Roychoudhury S, Majumder HK, Mondal TK, Das S. Anticancer Activity of a Complex of CuIIwith 2-(2-hydroxyphenylazo)-indole-3/-acetic Acid on three different Cancer Cell Lines: A Novel Feature for Azo Complexes. ChemistrySelect 2017. [DOI: 10.1002/slct.201601270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Durba Ganguly
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata-700 032 India
| | - Chetan Kumar Jain
- Cancer Biology & Inflammatory Disorder Division; Indian Institute of Chemical Biology; Kolkata-700032, India
- Infectious Diseases and Immunology Division; Indian Institute of Chemical Biology; Kolkata-700032 India
| | - Ramesh Chandra Santra
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata-700 032 India
| | - Susanta Roychoudhury
- Cancer Biology & Inflammatory Disorder Division; Indian Institute of Chemical Biology; Kolkata-700032, India
| | - Hemanta Kumar Majumder
- Infectious Diseases and Immunology Division; Indian Institute of Chemical Biology; Kolkata-700032 India
| | - Tapan Kumar Mondal
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata-700 032 India
| | - Saurabh Das
- Department of Chemistry (Inorganic Section); Jadavpur University; Kolkata-700 032 India
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18
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Pinto F, Große‐Büning S, Karsai S, Weiß C, Bäumler W, Hammes S, Felcht M, Raulin C. Neodymium‐doped yttrium aluminium garnet (Nd:
YAG
) 1064‐nm picosecond laser vs. Nd:
YAG
1064‐nm nanosecond laser in tattoo removal: a randomized controlled single‐blind clinical trial. Br J Dermatol 2017; 176:457-464. [DOI: 10.1111/bjd.14962] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 12/23/2022]
Affiliation(s)
- F. Pinto
- Pinto Medical Spa Centro Laser Dermatologico Roma Rome Italy
| | - S. Große‐Büning
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
| | - S. Karsai
- Department of Dermatology Klinikum Darmstadt Darmstadt Germany
- Department of Dermatology University Hospital Greifswald Ferdinand‐Sauerbruchstraße Greifswald Germany
| | - C. Weiß
- Department of Medical Statistics, Biomathematics and Information Processing Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - W. Bäumler
- Department of Dermatology Regensburg University Hospital Regensburg Germany
| | - S. Hammes
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
| | - M. Felcht
- Department of Dermatology, Venereology and Allergy University Medical Centre Mannheim Centre of Excellence of Dermatology of Baden‐Wuerttemberg Ruprecht‐Karls‐University of Heidelberg Mannheim Germany
| | - C. Raulin
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
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19
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Laux P, Tralau T, Tentschert J, Blume A, Dahouk SA, Bäumler W, Bernstein E, Bocca B, Alimonti A, Colebrook H, de Cuyper C, Dähne L, Hauri U, Howard PC, Janssen P, Katz L, Klitzman B, Kluger N, Krutak L, Platzek T, Scott-Lang V, Serup J, Teubner W, Schreiver I, Wilkniß E, Luch A. A medical-toxicological view of tattooing. Lancet 2016. [PMID: 26211826 DOI: 10.1016/s0140-6736(15)60215-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Long perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.
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Affiliation(s)
- Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Tewes Tralau
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Jutta Tentschert
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Annegret Blume
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Sascha Al Dahouk
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Wolfgang Bäumler
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Regensburg, Germany
| | | | | | | | | | | | | | - Urs Hauri
- Kantonales Laboratorium Basel-Stadt, Basel, Switzerland
| | - Paul C Howard
- US Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | - Paul Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Linda Katz
- US Food and Drug Administration, College Park, MD, USA
| | - Bruce Klitzman
- Duke University Medical Center, Research Park, Durham, NC, USA
| | - Nicolas Kluger
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lars Krutak
- Smithsonian Institution, Washington, DC, USA
| | - Thomas Platzek
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | | | - Jørgen Serup
- Bispebjerg University Hospital, Department of Dermatology, The Tattoo Clinic, Copenhagen, Denmark
| | | | - Ines Schreiver
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Elena Wilkniß
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
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20
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Ganguly D, Jain CK, Chandra Santra R, Roychoudhury S, Majumder HK, Das S. The biological in vitro effect and selectivity shown by a CoIIcomplex of 2-(2-hydroxyphenylazo)-indole-3′-acetic acid on three distinctly different cancer cells. RSC Adv 2016. [DOI: 10.1039/c6ra23163b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Reductive cleavage of azo bond in a CoIIcomplex of HPIA decreased significantly implying less toxicity. On human colon carcinoma HCT116, ALL MOLT-4 & MCF-7 breast cancer cells complex was more effective than HPIA but less toxic towards normal cells.
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Affiliation(s)
- Durba Ganguly
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata – 700 032
- India
| | - Chetan Kumar Jain
- Cancer Biology & Inflammatory Disorder Division
- Indian Institute of Chemical Biology
- Kolkata-700032
- India
- Infectious Diseases and Immunology Division
| | - Ramesh Chandra Santra
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata – 700 032
- India
| | - Susanta Roychoudhury
- Cancer Biology & Inflammatory Disorder Division
- Indian Institute of Chemical Biology
- Kolkata-700032
- India
| | - Hemanta Kumar Majumder
- Infectious Diseases and Immunology Division
- Indian Institute of Chemical Biology
- Kolkata-700032
- India
| | - Saurabh Das
- Department of Chemistry (Inorganic Section)
- Jadavpur University
- Kolkata – 700 032
- India
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21
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Neale PA, Stalter D, Tang JYM, Escher BI. Bioanalytical evidence that chemicals in tattoo ink can induce adaptive stress responses. JOURNAL OF HAZARDOUS MATERIALS 2015; 296:192-200. [PMID: 25929673 DOI: 10.1016/j.jhazmat.2015.04.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 06/04/2023]
Abstract
Tattooing is becoming increasingly popular, particularly amongst young people. However, tattoo inks contain a complex mixture of chemical impurities that may pose a long-term risk for human health. As a first step towards the risk assessment of these complex mixtures we propose to assess the toxicological hazard potential of tattoo ink chemicals with cell-based bioassays. Targeted modes of toxic action and cellular endpoints included cytotoxicity, genotoxicity and adaptive stress response pathways. The studied tattoo inks, which were extracted with hexane as a proxy for the bioavailable fraction, caused effects in all bioassays, with the red and yellow tattoo inks having the greatest response, particularly inducing genotoxicity and oxidative stress response endpoints. Chemical analysis revealed the presence of polycyclic aromatic hydrocarbons in the tested black tattoo ink at concentrations twice the recommended level. The detected polycyclic aromatic hydrocarbons only explained 0.06% of the oxidative stress response of the black tattoo ink, thus the majority of the effect was caused by unidentified components. The study indicates that currently available tattoo inks contain components that induce adaptive stress response pathways, but to evaluate the risk to human health further work is required to understand the toxicokinetics of tattoo ink chemicals in the body.
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Affiliation(s)
- Peta A Neale
- The University of Queensland, National Research Centre for Environmental Toxicology (Entox), Brisbane, QLD 4108, Australia.
| | - Daniel Stalter
- The University of Queensland, National Research Centre for Environmental Toxicology (Entox), Brisbane, QLD 4108, Australia
| | - Janet Y M Tang
- The University of Queensland, National Research Centre for Environmental Toxicology (Entox), Brisbane, QLD 4108, Australia
| | - Beate I Escher
- The University of Queensland, National Research Centre for Environmental Toxicology (Entox), Brisbane, QLD 4108, Australia
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22
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Gaudron S, Ferrier-Le Bouëdec MC, Franck F, D'Incan M. Azo pigments and quinacridones induce delayed hypersensitivity in red tattoos. Contact Dermatitis 2014; 72:97-105. [DOI: 10.1111/cod.12317] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Sophie Gaudron
- Department of Dermatology; Université d'Auvergne, CHU Clermont-Ferrand Hôpital Estaing; Lucie et Raymond Aubrac 63003 Clermont-Ferrand France
| | - Marie-Christine Ferrier-Le Bouëdec
- Department of Dermatology; Université d'Auvergne, CHU Clermont-Ferrand Hôpital Estaing; Lucie et Raymond Aubrac 63003 Clermont-Ferrand France
| | - Frederic Franck
- Department of Pathology; Université d'Auvergne, CHU Clermont-Ferrand Hôpital Estaing; Lucie et Raymond Aubrac 63003 Clermont-Ferrand France
| | - Michel D'Incan
- Department of Dermatology; Université d'Auvergne, CHU Clermont-Ferrand Hôpital Estaing; Lucie et Raymond Aubrac 63003 Clermont-Ferrand France
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23
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Lehner K, Santarelli F, Vasold R, Penning R, Sidoroff A, König B, Landthaler M, Bäumler W. Black tattoos entail substantial uptake of genotoxicpolycyclic aromatic hydrocarbons (PAH) in human skin and regional lymph nodes. PLoS One 2014; 9:e92787. [PMID: 24670978 PMCID: PMC3966813 DOI: 10.1371/journal.pone.0092787] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 02/26/2014] [Indexed: 01/31/2023] Open
Abstract
Hundreds of millions of people worldwide have tattoos, which predominantly contain black inks consisting of soot products like Carbon Black or polycyclic aromatic hydrocarbons (PAH). We recently found up to 200 μg/g of PAH in commercial black inks. After skin tattooing, a substantial part of the ink and PAH should be transported to other anatomical sites like the regional lymph nodes. To allow a first estimation of health risk, we aimed to extract and quantify the amount of PAH in black tattooed skin and the regional lymph nodes of pre-existing tattoos. Firstly, we established an extraction method by using HPLC – DAD technology that enables the quantification of PAH concentrations in human tissue. After that, 16 specimens of human tattooed skin and corresponding regional lymph nodes were included in the study. All skin specimen and lymph nodes appeared deep black. The specimens were digested and tested for 20 different PAH at the same time.PAH were found in twelve of the 16 tattooed skin specimens and in eleven regional lymph nodes. The PAH concentration ranged from 0.1–0.6 μg/cm2 in the tattooed skin and 0.1–11.8 μg/g in the lymph nodes. Two major conclusions can be drawn from the present results. Firstly, PAH in black inks stay partially in skin or can be found in the regional lymph nodes. Secondly, the major part of tattooed PAH had disappeared from skin or might be found in other organs than skin and lymph nodes. Thus, beside inhalation and ingestion, tattooing has proven to be an additional, direct and effective route of PAH uptake into the human body.
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Affiliation(s)
- Karin Lehner
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | | | - Rudolf Vasold
- Department of Organic Chemistry, University of Regensburg, Regensburg, Germany
| | - Randolph Penning
- Department of Forensic Medicine, Ludwig Maximilian University, Munich, Germany
| | - Alexis Sidoroff
- Department of Dermatology and Venereology, University of Innsbruck, Innsbruck, Austria
| | - Burkhard König
- Department of Organic Chemistry, University of Regensburg, Regensburg, Germany
| | - Michael Landthaler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - Wolfgang Bäumler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
- * E-mail:
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