True blue football fan: Tattoo reaction confined to blue pigment

Yoong, Corinne; Vun, Yin; Spelman, Lynda; Muir, James

doi:10.1111/j.1440-0960.2009.00608.x

Cited by 18 publications

(12 citation statements)

References 9 publications

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“…Although reactions to red, 7-16 purple, [17][18] green, 19 blue, [20][21][22][23][24] brown, 25 and black 16,[26][27][28] have been reported, mercuric sulfide (red pigment) is the most common irritant in tattoo hypersensitivity. 2,[7][8][9][10] Modern red pigment alternatives such as cadmium selenide (cadmium red), ferric hydrate (sienna/red ochre), and organic vegetable dyes such as brazilwood and sandalwood are still causing red dye hypersensitivities.…”

Section: Tattoo Hypersensitivity and Systemic Sarcoidosis 315mentioning

confidence: 99%

Systemic Sarcoidosis and Red Dye Granulomatous Tattoo Inflammation after Influenza Vaccination: A Case Report and Review of Literature

Psaltis

Gardner

Denton

2014

Ocular Immunology and Inflammation

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Section: Tattoo Hypersensitivity and Systemic Sarcoidosis 315mentioning

confidence: 99%

Systemic Sarcoidosis and Red Dye Granulomatous Tattoo Inflammation after Influenza Vaccination: A Case Report and Review of Literature

Psaltis

Gardner

Denton

2014

Ocular Immunology and Inflammation

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“…Cutaneous sarcoidosis may present in conjunction with systemic findings or as the sole manifestation of disease. Multiple case reports have described sarcoidosis initially presenting as granulomas in single tattooed skin up to one year after placement [1,3].…”

Section: Commentmentioning

confidence: 99%

Granulomatous Reaction Confined to Two Blue-ink Tattoos after H1N1 Influenza Vaccine

Marc¹,

Ler²,

Tonkovic-Capin³

et al. 2010

J Vaccin Vaccinat

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A 33-year-old white female presented to dermatology clinic with a three-month history of swelling and itching of blue-ink tattoos over each of her deltoid muscles. These symptoms began within one week of receiving intramuscular H1N1 vaccine (Sanofi-Pasteur, multidose vial containing 0.01% thimerosal, lot number UP005AA with expiration date March 15th 2011) into the right deltoid muscle superior to the tattoo on the right deltoid. These tattoos were placed eight years prior at different tattoo parlors. The patient denied past cutaneous eruptions or history of sarcoidosis or other vaccines or tattoos during this period. Past medical history included depression treated with depakote and haloperidol; hysterectomy with right oophorectomy and obesity. No medications had changed in the previous four months. Social history included occasional alcohol use but no tobacco or intravenous drug abuse. Physical examination showed induration confined to the blue-ink containing skin of two tattoos over the patient's deltoid muscles ( Figure 1). Other tattoos containing black, red and yellow ink were not affected.Histology of the punch biopsy specimen revealed noncaseating granulomas containing fine black granules (Figure 2). Staining revealed no evidence of acid-fast bacilli or fungi. Pathohistological differential diagnosis was sarcoidosis versus granulomatous reaction to pigment granules.Workup for sarcoidosis included chest X-rays, pulmonary function testing, ophthalmological examination and angiotensin converting enzyme serum levels. All studies were within normal limits except for pulmonary function testing which revealed a moderate restrictive lung defect. The patient declined further workup, as well as referral to a pulmonologist. A diagnosis was made of granulomatous reaction confined to blue-ink tattoos possibly triggered by H1N1 vaccine. After failing a trial of clobetasol ointment twice daily the patient is currently well-controlled with intralesional injections of triamcinolone acetonide. CommentNoncaseating granulomas in patients with edema and pruritus of tattoos have been attributed to both sarcoidosis and delayed type hypersensitivity reactions.1 Sarcoidosis cannot be excluded even if foreign pigment is found in a biopsy site [1].Sarcoidosis is a common disorder of the lungs and skin with AbstractNoncaseating granulomas occur due to a hypersensitivity reaction to an exogenous antigen. The introduction of the H1N1 vaccine has been successful in disease prevention but we expand the current literature on possible adverse reactions to the vaccine to include granulomatous reactions.

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“…Although allergic reactions to tattoo ink are somewhat uncommon, they are regularly seen by dermatologic laser surgeons due to the prevalence of tattoos in general . Many types of allergic reactions to tattoo ink have been reported, in addition to the more typical allergic contact dermatitis , including: lichenoid reactions , pseudolymphomatous reactions , morphea like reactions granuloma annulare‐like reactions , vasculitis , angioedema , and even anaphylactic reactions .…”

Section: Discussionmentioning

confidence: 99%