Skin diseases and tattoos: a five-year experience

Koebner phenomenon leading to the formation of new psoriatic lesions: evidences and mechanisms

“…There has been an exponential increase in the decorative tattooing as body art in the last two decades. However, a large number of studies have shown the development of new psoriatic lesions after tattooing skin as a Koebner reaction [18,[39][40][41][42][43]. The other factors/agents that are reported to exacerbate psoriasis as Koebner reaction include megavoltage irradiations [44], radiotherapy for carcinoma of breast [45], exposure to purified protein derivative (PPD)/Mantoux test [46,47], surgical incision during breast reconstruction [19,48], needle acupuncture [49], prosthesis after amputation of the leg [50], secondary syphilis [51], cupping therapy, a traditional Chinese medicine [52,53], striae distensae and striae gravidarum [17,54], ECG [55], itching (one of the core features of psoriasis)-induced skin injury [56], and viral infection-induced hand-foot-and-mouth disease [57].…”

“…Moreover, the development of dactylitis (inflammation of an entire digit, finger, or toe) in psoriatic arthritis has been linked with deep Koebner phenomenon of the flexor tendon-associated accessory pulleys [16]. Indeed, a number of agents/triggers have been reported to induce the development of new psoriatic lesions in healthy skin areas and these include, tattooing skin, radiations, skin incision, viral infections, and striae etc [17][18][19]. The different mechanisms that may possibly contribute in inducing the development of new psoriatic lesions as Koebernization include the involvement of mast cell-derived inflammatory mediators [20][21][22], nerve growth factor (NGF) and its receptor system [23], vascular endothelial growth factor (VEGF) [24], α 2 β1 integrins [25], S100A7 (psoriasin) and S100A15 (koebnerisin) [26], increase in the ratio of CD4 + /CD8 + T cells [5], down-regulation of polycystins [27], down-regulation of atypical chemokine receptor 2 (ACKR2) [28], decreased expression of N-methyl-d-aspartate (NMDA) receptor (NMDAR) on the keratinocytes [29] and increase in chemokines [30].…”

Granulomatous Reactions from Tattoos Following BRAF Inhibitor Therapy

“…Probably, this phenomenon could respond to the Köbner effect, well known for granulomatous reactions [10]. On the other hand, granulomatous reactions have been described in tattoos [11]. However, in our patient, it is highly probable that the granulomatous reactions are associated with the BRAF inhibitor treatment as the patient had already had numerous tattoos for years.…”

Lichen planus pemphigoides after body tattooing

“…In terms of latency, localized lichen planus has been described 2 days to 4 weeks after acquiring the tattoo, 1,3,4 and generalized lichen planus has been described 4 days to 7 months after acquiring the tattoo 2,5,6,8 . The Koebner phenomenon refers to the development of lesions on previously normal skin secondary to trauma 9 ; the development of lichen planus at the tattoo site can sometimes also be considered as Koebner phenomenon, 10 especially in patients with pre‐existing dermatoses. Other causes of lichenoid skin reactions include exposure to aminoglycoside antibiotics 11 or gold salts 12 .…”