Mycobacterium chelonae Infection Due to Black Tattoo Ink Dilution

Abstract

toll-like receptor 7 agonist imiquimod has been used to treat cutaneous melanoma metastases, [5] although in small numbers of patients we have found it much less effective than diphencyprone in this setting. [3] Imiquimod is also >100 times more expensive than diphencyprone, which costs approximately $US1 per month. Lentigo maligna is another condition where excision may be cosmetically difficult and where topical immunotherapy can play a role. Currently reported cure rates for lentigo maligna using imiquimod are~50-88%. [6] Trials may now be indicated, initially with histologic confirmation of response, using diphencyprone for these lesions.

Outbreak ofMycobacterium chelonaeInfection Associated with Tattoo Ink

“…S ince 2003, a growing number of published case reports have linked tattooing with localized infections due to atypical mycobacteria. [1][2][3][4][5][6][7][8][9][10][11][12][13] Mycobacterium chelonae is a rapidly growing form of nontuberculous mycobacteria; overall, it is an uncommon cause of cutaneous infections. 14 We describe an investigation of an outbreak involving 19 persons with presumed M. chelonae infection after receiving a tattoo from a single artist who used a premixed ink that was contaminated before distribution.…”

Microbial status and product labelling of 58 original tattoo inks

“…During the past few years several outbreaks of atypical mycobacterial infections, especially Mycobacterium chelonae in tattoo parlours have been reported. Case reports of M. chelonae in healthy adults presented with skin elements confined to the grey parts of their tattoos 21–23 . The grey wash was prepared by dilution of black pigment with tap water.…”

“…Case reports of M. chelonae in healthy adults presented with skin elements confined to the grey parts of their tattoos. [21][22][23] The grey wash was prepared by dilution of black pigment with tap water. Use of tap water mixed with the ink by the tattooist may be the cause of such contamination.…”

Mycobacterium chelonaeinfection: a complication of tattooing

“…Local skin infections may occur after trauma, and disseminated cutaneous disease is seen in immunocompromised patients. The largest outbreak to date of M. chelonae infection in tattoos was reported from France, 1 but there have been several cases elsewhere, 2–5 with a similar clinical picture of inflammatory skin lesions confined to the grey areas of tattoos. In many of the previously reported cases, the implicated source of M. chelonae has been non‐sterile water used to dilute black ink to grey, or to clean instruments and mixing vessels.…”