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Shin J, Leger M. Tattoo pruritus successfully treated with ruxolitinib: A case series. JAAD Case Rep 2024; 47:107-109. [PMID: 38699580 PMCID: PMC11063527 DOI: 10.1016/j.jdcr.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Affiliation(s)
| | - Marie Leger
- Assistant Professor of Dermatology at Mount Sinai, Entière Dermatology, New York, New York
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2
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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] [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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3
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Szulia A, Antoszewski B, Zawadzki T, Kasielska-Trojan A. When Body Art Goes Awry-Severe Systemic Allergic Reaction to Red Ink Tattoo Requiring Surgical Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10741. [PMID: 36078458 PMCID: PMC9517851 DOI: 10.3390/ijerph191710741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
The aim of this report is to present a case of a patient who developed unusual systemic hypersensitivity reaction to a red-pigmented tattoo and to discuss diagnostic difficulties in case of systemic reactions to tattoo ink. The patient reported erythroderma on his arms and chest accompanied by plaque elevation of red parts of his most recently performed forearm tattoo as his primary symptoms. His health condition entailed a prolonged topical and intravenous immunosuppressive therapy, which proved ineffective. Over a year after emergence of initial symptoms, he presented to the Plastic Surgery Clinic with generalized erythroderma, systemic lymphadenopathy, elevation and granuloma formation in red tattoos on his forearm and complaints of fatigue and inability to participate fully in work-related and social activities. The patient underwent six staged excisions with direct closures, flap plasties and full-thickness skin grafts. Following completion of each surgical resection, the patient's symptoms gradually subsided. We find this case illustrative of a clinical challenge that delayed hypersensitivity reactions to red tattoos may pose. Furthermore, we provide insights on management of hypersensitivity reactions. This report underlines the importance of social awareness of and public health approach to tattoo complications as key to successful prevention, identification and treatment of adverse reactions to tattoos.
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Affiliation(s)
- Agata Szulia
- The Military Medical Faculty, Medical University of Lodz, 90-419 Lodz, Poland
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Tomasz Zawadzki
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
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4
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van der Bent SAS, Huisman S, Rustemeyer T, Wolkerstorfer A. Ablative laser surgery for allergic tattoo reactions: a retrospective study. Lasers Med Sci 2021; 36:1241-1248. [PMID: 33104896 PMCID: PMC8282569 DOI: 10.1007/s10103-020-03164-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/15/2020] [Indexed: 11/24/2022]
Abstract
Patients with allergic tattoo reactions are burdened with itch and have a reduced quality of life. Conservative treatment is often insufficient and little is known about treatment options to remove the responsible allergen. We aimed to address the effectiveness and safety of ablative laser therapy including measurement of patient's satisfaction, in patients with allergic reactions to tattoos. A retrospective study was conducted including patients with allergic tattoo reactions who were treated with a 10,600 nm ablative CO2 laser, either by full-surface ablation or fractional ablation. Clinical information originated from medical files and a 25-item questionnaire. Sixteen tattoo allergy patients were treated with a CO2 laser between January 2010 and January 2018. Fourteen patients completed the questionnaire. Ten patients were satisfied with laser treatment. On a visual analogue scale, pruritus and burning improved with a median of 5.5 and 4 points in the full surface ablation group and 3 points on both parameters in the fractional ablation group. Despite the relatively small group of patients, our results suggest that CO2 laser ablation improves itching, burning and impact on daily life in tattoo allergy.
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Affiliation(s)
- S A S van der Bent
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, 2205 AZ, Amsterdam, The Netherlands
| | - Sanne Huisman
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, 2205 AZ, Amsterdam, The Netherlands.
| | - T Rustemeyer
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, 2205 AZ, Amsterdam, The Netherlands
| | - A Wolkerstorfer
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, 2205 AZ, Amsterdam, The Netherlands
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5
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Abstract
The art of tattooing is a popular decorative approach for body decoration and has a corrective value for the face. The tattooing procedure is characterized by placing exogenous pigments into the dermis with a number of needles. The process of creating traditional and cosmetic tattoos is the same. Colorants are deposited in the dermis by piercing the skin with needles of specific shape and thickness, which are moistened with the colorant. Colorants (pigments or dyes) most of the time include impurities which may cause adverse reactions. It is commonly known that tattoo inks remain in the skin for lifetime. It is also a fact that the chemicals that are used in permanent makeup (PMU) colorants may stay in the body for a long time so there is a significant long-term risk for harmful ingredients being placed in the body. Tattoo and PMU colorants contain various substances and their main ingredients and decomposition components may cause health risks and unwanted side effects to skin.
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van der Bent S, Oyen E, Rustemeyer T, Jaspars L, Hoekzema R. Histopathology of Red Tattoo Reactions. Am J Dermatopathol 2021; 43:331-337. [PMID: 32732691 DOI: 10.1097/dad.0000000000001751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite popularity of tattoos, complications may occur. In particular, red tattoo reactions due to allergic reactions are the most frequent chronic tattoo reactions. However, little is known about its histopathology and underlying pathomechanisms. OBJECTIVE The aim of this article is to analyze the histopathology of red tattoo reactions for diagnostic purposes and to acquire more insight into pathogenesis. METHODS A retrospective cross-sectional study was conducted by reviewing the histopathology of 74 skin biopsies of patients with allergic red tattoo reactions. Histopathological findings, such as inflammation patterns, inflammatory cells and pigment depth and color, were semi-quantified with an in-house validated scoring system by 2 independent senior investigators. RESULTS Histiocytes and lymphocytes were both present in >93%. Histiocytes were the predominant inflammatory cells in 74.3%, but well-defined granulomas were mostly absent (78.0%). Eosinophils were uncommon (8.1%) The predominantly histiocytic reaction combined with interface dermatitis was the main inflammation pattern (37.9%). Most biopsies showed more than one reaction pattern. Interface involvement was observed in 64.8%, despite the intended depth of standard tattoo procedures, in which pigment is placed deeper, in the upper- and mid-dermis. Statistical analyses showed a significant association between inflammation severity and pigment depth (P = 0.024). In 6 cases (8.1%) pigments could not be retrieved histologically. CONCLUSIONS In this cohort we demonstrated that cutaneous reactions to red tattoo ink are frequently characterized by the combination of dermal predominantly histiocytic infiltrates and epidermal interface dermatitis. Allergic reactions to red tattoo pigments probably represent a combination of a subtype IVa and IVc allergic reaction. Clinicians should be aware of the specific histopathology of these reactions and therefore the importance of taking a diagnostic skin biopsy.
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Affiliation(s)
- Sebastiaan van der Bent
- Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands ; and
| | - Ellen Oyen
- Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands ; and
| | - Thomas Rustemeyer
- Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands ; and
| | - Lies Jaspars
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Rick Hoekzema
- Academic Tattoo Clinic Amsterdam, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands ; and
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7
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Kluger N. Nickel and tattoos: Where are we? Contact Dermatitis 2021; 85:136-140. [PMID: 33880790 DOI: 10.1111/cod.13869] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/13/2021] [Accepted: 04/19/2021] [Indexed: 12/17/2022]
Abstract
Tattoos are not mentioned as a source of exposure to nickel. Traces of nickel are, however, almost inevitably found in tattoo inks as impurities and sometimes in tattooed skin. Whether nickel in tattoos has any health consequence is debated. We performed a narrative review of what is currently known about this topic. Today, nickel is frequently detected in inks, but at highly variable levels. It appears to be at higher concentrations in green, blue, and sometimes brown and violet inks. Only nickel allergy in tattooed individuals and nickel-associated tattoo ink allergy are addressed in the literature. Reports of tattoo ink allergy related to nickel are rare and heterogenous. Authors often neglect possible implications of other metals or dyes. A positive patch test is not enough to confirm the role of nickel in a reaction observed after tattooing. We found no report of any systemic complication attributed to nickel from tattoos. The Council of Europe ResAP(2008)1 bans the presence of nickel at high levels in tattoo inks, which is a safety net for individuals with nickel allergy. Large epidemiologic case-control studies with systematic biopsies on normal and inflamed tattoos and patch testing would help to understand the role of nickel in tattoo ink allergies.
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Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, Allergology and Venereology, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
- "Tattoo" Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
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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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9
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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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Kluger N. Tattoo side effects worldwide: a Google Trends–based time series analysis. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bent S, Winter R, Wolkerstorfer A, Rustemeyer T. Red tattoo reactions, a prospective cohort on clinical aspects. J Eur Acad Dermatol Venereol 2019; 33:e384-e386. [DOI: 10.1111/jdv.15677] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S.A.S. Bent
- Academic Tattoo Clinic AmsterdamDepartment of Dermatology and Allergology VU University Medical Center 1081 HV Amsterdam The Netherlands
| | - R.W. Winter
- Academic Tattoo Clinic AmsterdamDepartment of Dermatology and Allergology VU University Medical Center 1081 HV Amsterdam The Netherlands
| | - A. Wolkerstorfer
- Department of Dermatology Academic Medical Center University of Amsterdam 1105 AZ Amsterdam The Netherlands
| | - T. Rustemeyer
- Academic Tattoo Clinic AmsterdamDepartment of Dermatology and Allergology VU University Medical Center 1081 HV Amsterdam The Netherlands
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13
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Darvin ME, Schleusener J, Parenz F, Seidel O, Krafft C, Popp J, Lademann J. Confocal Raman microscopy combined with optical clearing for identification of inks in multicolored tattooed skin in vivo. Analyst 2018; 143:4990-4999. [PMID: 30225475 DOI: 10.1039/c8an01213j] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Raman measurements applied on freshly tattooed porcine skin ex vivo showed a possibility of obtaining the ink pigment related information in the skin. Based on these results, confocal Raman microscopy was used to identify the tattoo ink pigments of different colors in multicolored tattooed human skin in vivo. The Raman signatures of tattoo ink pigments were unique. Therefore, it could be shown that the applied method is successful for the identification of the tattoo ink pigments in human skin in vivo down to depths of approx. 50 μm, which is sufficient to screen the entire epidermis and the top of the papillary dermis area on the forearm and leg skin sites. Additional application of the optical clearing technique in vivo by topical application of glycerol, combined with tape stripping removal of the uppermost stratum corneum layers and defatting allows the extension of depths of investigation in tattooed skin down to approx. 400 μm, i.e. to cover the entire papillary dermis and a large part of the reticular dermis. Thus, the tattoo ink pigments were identified in vivo and depth-dependently in human tattooed skin confirming their presence in the papillary and reticular dermis. The proposed non-invasive in vivo Raman screening combined with optical clearing for identifying the tattoo pigments in the dermis can be an important task preceding a laser-based tattoo removal procedure and for determining the optimal laser parameters.
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Affiliation(s)
- Maxim E Darvin
- Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charitéplatz 1, 10117 Berlin, Germany.
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14
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Huisman S, Bent SAS, Wolkerstorfer A, Rustemeyer T. Granulomatous tattoo reactions in permanent makeup of the eyebrows. J Cosmet Dermatol 2018; 18:212-214. [DOI: 10.1111/jocd.12540] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sanne Huisman
- Academic Tattoo Clinic Amsterdam Department of Dermatology VU University Medical Centre Amsterdam The Netherlands
| | - Sebastiaan A. S. Bent
- Academic Tattoo Clinic Amsterdam Department of Dermatology VU University Medical Centre Amsterdam The Netherlands
| | - Albert Wolkerstorfer
- Academic Tattoo Clinic Amsterdam Department of Dermatology Academic Medical Centre Amsterdam The Netherlands
| | - Thomas Rustemeyer
- Academic Tattoo Clinic Amsterdam Department of Dermatology VU University Medical Centre Amsterdam The Netherlands
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15
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Réactions dites « allergiques » aux tatouages : prise en charge et algorithme thérapeutique. Ann Dermatol Venereol 2016; 143:436-45. [DOI: 10.1016/j.annder.2016.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/02/2016] [Accepted: 03/17/2016] [Indexed: 11/19/2022]
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16
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Kluger N. Cutaneous and systemic complications associated with tattooing. Presse Med 2016; 45:567-76. [PMID: 27160631 DOI: 10.1016/j.lpm.2016.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/28/2016] [Accepted: 02/08/2016] [Indexed: 12/31/2022] Open
Abstract
Tattooing can result in a wide variety of complications, whose prevalence and incidence remain still unclear. Hypersensitivity reactions (or allergies) to tattoo pigments are currently the most common complication on a tattoo, however they are not predictable. Infections are nowadays directly related to the lack of asepsis and hygiene during the tattooing procedure or during the healing phase. Patients with a known cutaneous disease should be warned of a potential risk of localization of their disease to the tattoo. A skin eruption restricted to a tattoo may reveal sarcoidosis. Patients with chronic conditions and/or impaired immunity should discuss with their physician about the possibility and when to have a tattoo.
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Affiliation(s)
- Nicolas Kluger
- University of Helsinki, Helsinki University Central Hospital, dermatology, allergology and venereology, Meilahdentie 2, P.O. Box 160, FI-00029 HUS, Finland.
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17
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Hutton Carlsen K, Køcks M, Sepehri M, Serup J. Allergic reactions in red tattoos: Raman spectroscopy for 'fingerprint' detection of chemical risk spectra in tattooed skin and culprit tattoo inks. Skin Res Technol 2016; 22:460-469. [PMID: 26991512 DOI: 10.1111/srt.12287] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to assess the feasibility of Raman spectroscopy as a screening technique for chemical characterisation of tattoo pigments in pathologic reacting tattoos and tattoo ink stock products to depict unsafe pigments and metabolites of pigments. MATERIALS/METHODS Twelve dermatome shave biopsies from allergic reactions in red tattoos were analysed with Raman spectroscopy (A 785-nm 300 mW diode laser). These were referenced to samples of 10 different standard tattoo ink stock products, three of these identified as the culprit inks used by the tattooist and thus by history the source of the allergy. Three primary aromatic amine (PAA) laboratory standards (aniline, o-anisidine and 3,3'-dichlorobenzidine) were also studied. RESULTS Application of Raman spectroscopy to the shave biopsies was technically feasible. In addition, all ten inks and the three PAA standards could be discriminated. 10/12 shave biopsies provided clear fingerprint Raman signals which differed significantly from background skin, and Raman spectra from 8/12 biopsies perfectly matched spectra from the three culprit ink products. The spectrum of one red ink (a low cost product named 'Tattoo', claimed to originate from Taiwan, no other info on label) was identified in 5/12 biopsies. Strong indications of the inks 'Bright Red' and 'Crimson Red' were seen in three biopsies. The three PAA's could not be unambiguously identified. CONCLUSION This study, although on a small-scale, demonstrated Raman spectroscopy to be feasible for chemical analysis of red pigments in allergic reactions. Raman spectroscopy has a major potential for fingerprint screening of problematic tattoo pigments in situ in skin, ex vivo in skin biopsies and in tattoo ink stock products, thus, to eliminate unsafe ink products from markets.
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Affiliation(s)
- K Hutton Carlsen
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark.
| | - M Køcks
- Chemistry and Biotechnology, Danish Technological Institute, Aarhus, Denmark
| | - M Sepehri
- Centre of Wound Healing, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Serup
- Department of Dermatology, The "Tattoo Clinic", Bispebjerg University Hospital, Copenhagen, Denmark
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18
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Abstract
Tattoos are common and used extensively as either body art or cosmetic make-up; more rarely, they can be traumatic in nature. We have systemically analysed the literature for the patterns of red pigment tattoo reactions and their treatment options. Our search identified 18 articles; there was 1 non-randomised controlled trial, and the rest were small case studies. In total 139 patients were included within the studies. This review systematically analyses the different subsets of red tattoo reactions including lichenoid, dermatitis, granulomatous, pseudolymphomatous and miscellaneous reactions. The current evidence for the treatment for the above is presented. Dermatitis and lichenoid reactions appear to be the most common subtype of red pigment reactions with various treatment methods applied showing laser intervention to have some degree of success.
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19
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The Demographics and Rates of Tattoo Complications, Regret, and Unsafe Tattooing Practices: A Cross-Sectional Study. Dermatol Surg 2016; 41:1283-9. [PMID: 26509942 DOI: 10.1097/dss.0000000000000500] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Tattoos have become increasingly common in the United States; however, there are limited data on the rates of tattoo complications and tattoo regret. OBJECTIVE To determine the rates of infectious and allergic complications after tattooing, rates of tattoo regret, the perception of dermatologists among people with tattoos, and the demographics of people with tattoos. MATERIALS AND METHODS An 18-question cross-sectional survey was fielded in New Orleans in January 2015. Participants had to be at least 18 years old, have at least 1 tattoo, and reside within the United States. RESULTS In total, 501 participants from 38 American states were enrolled. Of all participants, 3.2% had a history of an infected tattoo, 3.8% had a history of a painful tattoo, and 21.2% had a history of a pruritic tattoo; 16.2% of participants regret a current tattoo and 21.2% are interested in having 1 or more tattoos removed; 21.2% received a tattoo while intoxicated and 17.6% had a tattoo placed somewhere other than at a tattoo parlor; and 78.9% believe dermatologists are knowledgeable about the infectious and allergic complications of tattoos. CONCLUSION Given the rates of pruritic tattoos and tattoo regret, there is an opportunity, and trust among people with tattoos, for dermatologists to manage these complications.
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Affiliation(s)
- Bo H. Jonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Regina Winzer
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Brady BG, Gold H, Leger EA, Leger MC. Self-reported adverse tattoo reactions: a New York City Central Park study. Contact Dermatitis 2015; 73:91-9. [DOI: 10.1111/cod.12425] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/13/2015] [Accepted: 04/27/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Bobbi G. Brady
- Department of Medicine; Norwalk Hospital; Norwalk CT 06850
| | - Heidi Gold
- Department of Medicine; Maimonides Medical Center; Brooklyn NY 11219
| | - Elizabeth A. Leger
- Department of Natural Resources and Environmental Science; University of Nevada; Reno NV 89557 USA
| | - Marie C. Leger
- Ronald O. Perelman Department of Dermatology; New York University; New York NY 10016 USA
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Sepehri M, Jørgensen B, Serup J. Introduction of dermatome shaving as first line treatment of chronic tattoo reactions. J DERMATOL TREAT 2015; 26:451-5. [PMID: 25672517 DOI: 10.3109/09546634.2014.999021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIMS Chronic tattoo reactions requiring treatment have increased. Laser removal is not ideal for removal of allergic reactions. Surgical removal of culprit pigment situated in the outer dermis by dermatome shaving is rational and need to be revisited. MATERIALS/METHODS Fifty four tattoos with chronic reactions in 50 patients were treated with dermatome shaving. Tattoos with red/red nuances dominated the material. In total, 52 operations were performed in infiltration and 2 in general anaesthesia. Shaving was performed to the level in the dermis free of tattoo pigment as assessed visually by the surgeon. RESULTS Operative complications were few. Healing occurred over weeks as normal for this procedure. On a rating scale from 0 to 4, 4 as most severe, the patient's severity rating of symptoms in their tattoo declined from 3.2 pre-operatively to 1.0, 0.8 and 0.7 after 3, 6 and 12 months, respectively. Burden of operation was rated low. Patient satisfaction was high. DISCUSSION/CONCLUSION Dermatome shaving is efficient and with few complications, and is proposed as first line treatment of chronic tattoo reactions. Shaving of such reactions apparently has been neglected during enthusiastic introduction of laser approaches, which in the treatment of allergic tattoo reactions may be relatively contra indicated and of special risk.
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Affiliation(s)
- Mitra Sepehri
- a Wound Healing Center, Bispebjerg University Hospital , Copenhagen , Denmark and
| | - Bo Jørgensen
- a Wound Healing Center, Bispebjerg University Hospital , Copenhagen , Denmark and
| | - Jørgen Serup
- b Department of Dermatology , Bispebjerg University Hospital , Copenhagen , Denmark
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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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