Are metals involved in tattoo‐related hypersensitivity reactions? A case report

Cuyper, Christa De; Lodewick, Evelyne; Schreiver, Ines; Hesse, Bernhard; Seim, Christian; Castillo‐Michel, Hiram; Laux, Peter; Luch, Andreas

doi:10.1111/cod.12862

Cited by 33 publications

(28 citation statements)

References 28 publications

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“…Ti allergy presents with heterogeneous clinical findings ranging from delayed wound healing, eczema or oedema to persistent fever . Similarly, histological patterns vary from eczematous or lichenoid to granulomatous reactions . To our knowledge, only 2 case reports of Ti allergy caused by surgical clips have been reported previously .…”

Section: Discussionmentioning

confidence: 95%

“…3,4 Similarly, histological patterns vary from eczematous or lichenoid to granulomatous reactions. 5 To our knowledge, only 2 case reports of Ti allergy caused by surgical clips have been reported previously. 6,7 The medical history of our patient, a positive patch test reaction to Ti oxide, complete recovery after clip removal and a granulomatous reaction adjacent to the clips indicated Ti hypersensitivity.…”

Section: Discussionmentioning

confidence: 98%

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Titanium hypersensitivity causing painful intra‐abdominal oedema after staple‐fixed inguinal hernia repair

et al. 2018

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

Titanium hypersensitivity causing painful intra‐abdominal oedema after staple‐fixed inguinal hernia repair

et al. 2018

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“…Titanium is used widely in metal implants and accepted to be rather nonallergenic. However, a recent case report suggested that titanium release from an implant as a contributing factor in tattoo‐related allergic reactions . The problem arose in black tattoos, in which the histology showed that granulomatous inflammation and patch tests with titanium were inconclusive, although the patient reacted to the processed implant material.…”

Section: Discussionmentioning

confidence: 99%

Identification of pigments related to allergic tattoo reactions in 104 human skin biopsies

et al. 2019

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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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“…The role of cross-reactions with cobalt and palladium, for example, would also still appear to be of significance [38]. However, whether and to what extent other products such as nickel-containing/contaminated tattoos can contribute to the positive results is still open to conjecture [39][40][41][42]. Unexpected products, such as permanent make-up, can also produce an allergic nickel reaction [43].…”

Section: Nickel In Consumer Productsmentioning

confidence: 99%

Consumer protection and risk assessment: sensitising substances in consumer products

Thierse

Luch

2019

Allergo J Int

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Background The human immune system is confronted daily with a large, chemically-varied range of potentially sensitising substances. Skin sensitising substances are found, above all, in a plethora of consumer products, e. g. cosmetics, jewellery, earrings, toys, textiles, leather, other everyday commodities and, in some cases, also tattoos. These products may contain sensitisers such as fragrances, preservatives, dyes, or other additives. To provide a greater degree of consumer protection, there is a need for specific legal regulation and risk assessment, which covers each possible human exposure to a sensitising substance or mixture. This review article describes the background and pathway towards the development and implementation of an international legal framework for the classification and labelling of chemicals that contain potentially skin sensitising substances. This includes the implementation of the globally harmonized system of classification and labelling of chemicals (GHS), the classification, labelling and packaging (CLP) regulation, registration, evaluation, authorisation and restriction of chemicals (REACH), and the regulation of cosmetics, among other national laws and regulations. Assessment criteria for classification is derived from a suite of in vitro and in vivo assays, Electronic supplementary material The online version of this article (

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Are metals involved in tattoo‐related hypersensitivity reactions? A case report

Abstract: The patient's hypersensitivity reaction and its spontaneous remission after removal of the implants indicate that Ti, possibly along with some of the other metals detected, could have played a major role in this particular case of tattoo-related allergy.

Cited by 33 publications

References 28 publications

Titanium hypersensitivity causing painful intra‐abdominal oedema after staple‐fixed inguinal hernia repair

Titanium hypersensitivity causing painful intra‐abdominal oedema after staple‐fixed inguinal hernia repair

Identification of pigments related to allergic tattoo reactions in 104 human skin biopsies

Consumer protection and risk assessment: sensitising substances in consumer products

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