Classification of Tattoo Complications in a Hospital Material of 493 Adverse Events

Serup, Jørgen; Sepehri, Mitra; Carlsen, Katrina Hutton

doi:10.1159/000452148

Cited by 91 publications

(142 citation statements)

References 35 publications

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“…Unbearable itch or pain was a reason for requesting tattoo removal. Red ink was the main culprit, but the actual allergens have not yet been identified [24,26] . It is widely acknowledged that patch-testing is not suitable for exploring tattoo allergies [24,27] and therefore we rarely use this test for tattoo reactions in our practice.…”

Section: Tattoo Allergy Is the Most Common Complication And Occurs Onmentioning

confidence: 99%

Cutaneous Complications Related to Tattoos: 31 Cases from Finland

Kluger¹

2017

Dermatology

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nodules to complete infiltration of a colour. Lesions were itchy and sometimes painful. The reactions were lichenoid, granulomatous, pseudolymphomatous or less specific with a dermal lympho-histiocytic or plasmocytic infiltrate. Other diagnoses included tattoo blow-out (13%), melanoma within a tattoo, naevi within a tattoo (10% each), lichen planus (6%), granulomatous reaction with uveitis, sarcoidosis and dermatofibroma (3% each). Allergic tattoo reactions were mainly treated with local corticosteroid (CS) ointments, CS infiltration or surgical removal. Conclusion: This review is the largest series of tattoo complications in the Baltic area. It illustrates the wide spectrum of complications. Prospective, controlled therapeutic studies are necessary to assess the best treatment protocols for tattoo allergies and tattoo reaction management in general.

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Section: Tattoo Allergy Is the Most Common Complication And Occurs Onmentioning

confidence: 99%

Cutaneous Complications Related to Tattoos: 31 Cases from Finland

Kluger¹

2017

Dermatology

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“…In our initial publication, "Classification of Tattoo Complications in a Hospital Material of 493 Adverse Events," we observed that black pigment and a papulonodular type of tattoo reaction by clinical examination are associated [11] . Sarcoid granulomas are clinically and by shape nodular.…”

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confidence: 99%

Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material

2016

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Background/Aims: Sarcoidosis is, from historical data, suggested to be more prevalent among patients with tattoo reactions. We aimed to evaluate this association in a systematic study. Methods: This is a consecutive study of patients with tattoo complications, diagnosed in the “Tattoo Clinic” at Bispebjerg University Hospital in Copenhagen, Denmark, from 2008 to 2015, based on clinical assessment and histology. From the overall group of 494 tattoo complications in 406 patients, 92 reactions in 72 patients showed a papulo-nodular pattern studied for local and systemic sarcoidosis, since sarcoidosis is expected to be nodular. Results: Of the 92 reactions with a papulo-nodular pattern, 27 (29%) reactions in 19 patients were diagnosed as cutaneous or systemic sarcoidosis, supported by histology; 65 (71%) were diagnosed as non-sarcoidosis due to histology and no clinical sarcoid manifestations. “Rush phenomenon” with concomitant reaction in many other black tattoos, triggered by a recent tattoo with a papulo-nodular reaction, was observed in 70% in the sarcoidosis group and 28% in the non-sarcoidosis group, indicating a predisposing factor which may be autoimmune and linked with sarcoidosis. Agglomerates of black pigment forming foreign bodies may in the predisposed individual trigger widespread reaction in the skin and internal organs. Conclusion: Black tattoos with papulo-nodular reactions should be seen as markers of sarcoidosis. Papulo-nodular reactions may, as triggers, induce widespread reactions in other black tattoos - a “rush phenomenon” - depending on individual predisposition. Sarcoidosis is estimated to be 500-fold increased in papulo-nodular reactions compared to the prevalence in the general population, and the association with black tattoos is strong.

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“…Mutagenic or reproduction-toxic events directly in humans have neither been reported. A large consecutive series of 405 patients with tattoo complications, published from our clinic, found no cases of malignant tumours in the skin or in the internal organs [18] . Old studies with 25-year follow-up from the Mayo Clinic in USA on extensive tar treatment of atopic dermatitis and psoriasis, supplemented with UVR given as Goeckerman therapy, failed to show increased risk of cancers in the skin and in internal organs [19][20][21] .…”

Section: Discussionmentioning

confidence: 88%

Search for Internal Cancers in Mice Tattooed with Inks of High Contents of Potential Carcinogens: A One-Year Autopsy Study of Red and Black Tattoo Inks Banned in the Market

Sepehri

Lerche²,

Carlsen³

et al. 2017

Dermatology

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Background and Objective: Tattoo ink stock products often contain potential carcinogens, which on large-scale population exposure may be clinically relevant. The aim of this autopsy study in mice was to screen major organs for clinical and subclinical cancers. Methods: Mice were tattooed on their backs. In total, 48 mice were included and divided into 4 groups; 11 mice tattooed black, 10 tattooed red, and 5 mice serving as untreated controls. A group of 22 mice with black tattoos and exposed to ultraviolet radiation (UVR) were also studied. The black and red inks were both stock products banned on the Danish market due to the measured contents of potential carcinogens; benzo(a)pyrene and 2-anisidine, respectively. The mice were housed for 1 year after tattooing, and autopsy study on internal organs was performed. Tissue samples were systematically taken from major organs for screening of subclinical changes, not detected by visual examination. Any observed deviation from normal structure was subject to biopsy and light microscopy. Results: All mice survived the 1-year observation period. Autopsy revealed no macroscopic signs of cancer. Microscopic search of internal organs showed no subclinical or clinical cancer. Conclusion: Despite extensive tattoos with 2 banned inks, the long-term observation in mice showed no internal cancers nor was the combination of carcinogen and UVR associated with cancer. Lack of observed malignancy might be explained by the fact that tattooing is only a single dose exposure. Registered data on carcinogens relies on repeated or chronic exposures. The study does not support the hypothesis that tattooing causes cancer.

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Classification of Tattoo Complications in a Hospital Material of 493 Adverse Events

Cited by 91 publications

References 35 publications

Cutaneous Complications Related to Tattoos: 31 Cases from Finland

Cutaneous Complications Related to Tattoos: 31 Cases from Finland

Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material

Search for Internal Cancers in Mice Tattooed with Inks of High Contents of Potential Carcinogens: A One-Year Autopsy Study of Red and Black Tattoo Inks Banned in the Market

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