Tattoos and human papilloma virus: A case report of tattoo-associated flat warts (verrucae planae)

Kirchhof, Mark G.; Wong, Se Mang

doi:10.1177/2050313x19857416

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…Difficult-to-treat HPV is a hallmark of primary immunodeficiency, although the mechanism is unclear because the host immune defense against HPV is multifaceted, with immunity provided by various immune cells as well as nonimmune cells such as keratinocytes (31,32). There have also been several cases reported of tattoo-associated HPV in otherwise immunocompetent individuals (33,34), but in these cases, the lesions are localized to the tattoo itself, unlike the patient who has widespread lesions. This suggests that the barrier disruption caused by tattooing may contribute to the host's lack of ability to mount an effective immune response against HPV.…”

Section: Discussionmentioning

confidence: 99%

Absence of mucosal-associated invariant T cells in a person with a homozygous point mutation in MR1

et al. 2020

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The role unconventional T cells play in protective immunity in humans is unclear. Mucosal-associated invariant T (MAIT) cells are an unconventional T cell subset restricted to the antigen-presenting molecule MR1. Here, we report the discovery of a patient homozygous for a rare Arg31His (R9H in the mature protein) mutation in MR1 who has a history of difficult-to-treat viral and bacterial infections. MR1R9H was unable to present the potent microbially derived MAIT cell stimulatory ligand. The MR1R9H crystal structure revealed that the stimulatory ligand cannot bind due to the mutation lying within, and causing structural perturbation to, the ligand-binding domain of MR1. While MR1R9H could bind and be up-regulated by a MAIT cell inhibitory ligand, the patient lacked circulating MAIT cells. This shows the importance of the stimulatory ligand for MAIT cell selection in humans. The patient had an expanded γδ T cell population, indicating a compensatory interplay between these unconventional T cell subsets.

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Section: Discussionmentioning

confidence: 99%

Absence of mucosal-associated invariant T cells in a person with a homozygous point mutation in MR1

et al. 2020

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“…The cutaneous infections can result from bacterial, fungal, mycobacterial, protozoan, spirochetal, and viral etiologies. Viral infections include those caused by human papillomavirus: verruca vulgaris, verruca plana, and epidermodysplasia verruciform [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…Tattoo-associated verruca plana have been described in 14 patients ranging in onset age from 20 to 48 years (median, 30 years) (Table 3) [1,3,[11][12][13][14][15][16][17][18]. The flat warts were diagnosed at ages ranging from 20 to 48 years (median, 33 years) in the five men and between the age of 21 and 39 years (median, 27 years) in the three women.…”

Section: Discussionmentioning

confidence: 99%

“…The number of flat warts was most frequently described as multiple (four patients). A 21-year-old man had 150 lesions, a 33-year-old man had 120 lesions, a 36-year-old man had 100s of verruca plana, and a 48-yearold man had more than two lesions (Table 4) [1,3,[11][12][13][14][15][16][17][18]. a Case 8: investigators reported human papillomavirus-induced cutaneous verruca plana (flat warts) presenting as multiple, 1-4 mm, skin-colored papules following the ink pattern of a feather-shaped tattoo [18].…”

Section: Discussionmentioning

confidence: 99%

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Verruca Vulgaris Occurring on a Tattoo: Case Report and Review of Tattoo-Associated Human Papillomavirus Infections

Cohen

2021

Cureus

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Cutaneous infections can occur on tattoos. Tattoo-associated viral infections can be caused by human papillomavirus. A verruca vulgaris developed on the tattoo of a 44-year-old woman; the viral lesion appeared 21 years after she received the tattoo and had been increasing in size during the prior five years. Biopsy of the lesion not only confirmed the diagnosis but also removed most of the wart; the patient declined any additional treatment. In addition to verruca vulgaris (27 individuals), verruca plana (14 individuals) and human immunodeficiency virus-associated acquired epidermodysplasia verruciformis (two men) are human papillomavirus lesions that have been observed to occur on tattoos. The latency period from receiving the tattoo to the appearance of the wart has ranged from one month to 21 years; the median duration was 21 months for verruca vulgaris and 24 months for verruca plana. The warts most frequently appeared in the dark, usually black, inked areas of the tattoo; indeed, it has been postulated that the ink created a cutaneous immunocompromised district that enhanced the opportunity for the viral lesions to occur in the tattoo. The use of contaminated instruments or ink during tattoo inoculation is the most likely etiology for the development of a wart on a tattoo. However, other potential mechanisms for human papillomavirus to occur on a tattoo include transmission of the virus from the tattoo artist's ungloved hand or saliva, a preexisting (albeit unrecognized) human papillomavirus lesion adjacent to or at the site of the tattoo, and postinoculation acquisition of the verruca at the site of the tattoo. Topical retinoid or imiquimod, used as a single agent, was not effective in the treatment of the warts. Some of the patients who were treated with cryotherapy using liquid nitrogen did not achieve any improvement of their viral lesions. However, other patients observed resolution of most or all their warts when cryotherapy with liquid nitrogen, either as monotherapy or followed by topical application of 5% imiquimod cream, was used; yet, following treatment, these individuals experienced mild distortion of their tattoo and/or hypopigmentation. Curettage and squaric acid dibutyl ester contact immunotherapy were both successful approaches to the management of tattoo-associated warts. In addition, warts were efficaciously managed with either photodynamic therapy or treatment with an ablative erbium:yttrium aluminum garnet (YAG) laser followed by topical application of 5% imiquimod cream.

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Viral Infections Confined to Tattoos—A Narrative Review

Tampa

Mitran

et al. 2022

Medicina

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Since ancient times, people have tattooed their skin for various reasons. In the past, tattoos were associated with low social status; nowadays, tattoos are very popular and are considered a form of art. However, tattoos are associated with various clinical problems, including immune reactions, inflammatory disorders, infections, and even skin cancer. Epidemiological and clinical data of infections on tattoos are scarce. Tattoo-related infections are mostly bacterial; only a few localized viral infections have been reported so far and are caused by molluscum contagiosum virus (MCV), human papillomavirus (HPV), and herpes simplex virus (HSV). In most cases, the lesions were strictly confined to the area of the tattoo. In this review, we have analysed reported cases of viral infections localized on tattoos and discussed the possible mechanisms involved in the occurrence of these infections.

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Tattoos and human papilloma virus: A case report of tattoo-associated flat warts (verrucae planae)

Cited by 4 publications

References 15 publications

Absence of mucosal-associated invariant T cells in a person with a homozygous point mutation in MR1

Absence of mucosal-associated invariant T cells in a person with a homozygous point mutation in MR1

Verruca Vulgaris Occurring on a Tattoo: Case Report and Review of Tattoo-Associated Human Papillomavirus Infections

Viral Infections Confined to Tattoos—A Narrative Review

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