“…5 Eventually, if a tattoo is present or has been present in any body area, the pigment can migrate to the regional lymph nodes through the lymphatic vessels and subsequently mimic metastatic disease from melanoma. 1,5 The methods used to remove tattoos, such as the Q-Switch laser, do not eradicate the presence of the pigment in the lymph nodes. 4,6 Other possible causes of pigmented lymph nodes are anthracitic pigment, dental amalgam, aluminium, titanium, dermatopathic lymphadenitis and hemosiderin-laden macrophages after local trauma or surgery.…”