Lichenoid tattoo hypersensitivity.

Abstract

Summary and conclusions Four patients are described who developed granulomatous reactions in the red portions of their tattoos. Histopathological and immunofluoreseence studies showed features of lichen planus. Mercury was identified in only one patient's lesion, and hypersensitivity to mercury was shown by patch testing in one other patient.Tattooing may provide a localised antigenic challenge resulting in spontaneously occurring lichen planus. IntroductionTattoos occasionally have intriguing and even disastrous consequences in addition to remorse. Fortunately most complications of tattoos are rare, but of the complications that do occur a granulomatous response in the red portion is the most common.

Azo pigments and quinacridones induce delayed hypersensitivity in red tattoos

“…For all 6 patients, biopsy specimens of the swollen red areas were examined. In 3 patients , biopsy showed a lichenoid reaction, with a band‐like dense lymphocytic infiltrate in the upper dermis and necrotic basal keratinocytes. In 2 patients , it showed a pseudolymphomatous reaction: a dermal infiltrate of small to medium‐sized CD4 + T cells expressing T follicular helper markers (CD10, CXCL13, Bcl6, and PD1), indicative of a T follicular helper pseudolymphomatous reaction, in patient 3 (Fig.…”

Lichen planus or lichenoid tattoo reaction?

“…In previous case reports where immunofluorescence was performed, no distinguishable characteristics from idiopathic LP were noted. 1 , 3 It is interesting to question whether our patient developed LP as an isomorphic response to tattoo trauma or whether the eruption was a manifestation of delayed hypersensitivity to the red tattoo. If it was LP, there is no explanation as to why the reaction was confined to the red‐colored areas.…”

“…Lichenoid reactions confined to red tattoos, without associated lichen planus (LP) elsewhere on the skin or mucosal membranes, have been described previously. 1–5 Spontaneous generalized LP involving a tattoo was described by Rook and Thomas 6 in 1952, but no predilection for one color was noted. We describe a patient who presented with an LP eruption on the skin and mucosal membranes and a lichenoid reaction confined to the red areas of his tattoo.…”

Clinicopathologic Features of Skin Reactions to Temporary Tattoos and Analysis of Possible Causes

“…Although lichenoid reactions to permanent tattoos, especially red dye, have been well known, [11][12][13] a lichenoid reaction to a paint-on tattoo has rarely been reported. Lestringant et al 7 in 1999 described a clinical lichenoid eruption due to tattooing with a henna mixture.…”