DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161845

Adverse reactions to tattoos: a study from the hilly region in northern India

Subhash Kashyap, Ajay Kumar

Abstract


Background: Body art in the form of ornamental tattoos has been prevalent since ages and is followed with increased popularity in modern times. Tattoo prevalence ranges from 8.5% to 24%, higher among younger ages. Two third of such people who ever had a tattoo reported of being regretted of having a tattoo itself while 2% have adverse reactions. The aim was to study the adverse reaction to tattoos and histological variants in the chronic tattoos.

Methods: An observational prospective study was conducted on patients presented with adverse reactions to tattoos in the out-patient department of dermatology, venereology and leprosy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India from July 2012 to June 2013. Relevant clinical profile of the patient was studied and histopathological examination with a 5 mm punch biopsy was done in chronic cases.

Results: A total of thirty-three cases (19 male and 14 females) with complications to tattoos were registered over the period of one year. Thirty patients had their tattoo from an amateur while only three had from a professional tattooist. Twenty one (63.6%) had acute complications and twelve (36.3%) had chronic complications. Histpathological examination (HPE) was done in ten of these cases and two refused biopsy. The findings were suggestive of lupus vulgaris (LV) and foreign body granuloma (FBG) in three each; chronic granulomatous changes in two, and spongiotic dermatitis (SD), and lichen planus hypertrophicus (LPH) in one case each.

Conclusions: Tattooing being largely unregulated has led to variability in contents of tattoo solution and inadequate sterilization during the procedure. This combined with lack of awareness, increases the chances of various adverse reactions. So it is extremely important to strictly regularize the tattoo practice and to increase awareness about tattoo complications among consumers, tattoo artists and dermatologists.


Keywords


Tattoo, Adverse reaction, Tattoo pigments, Tattoo granuloma

Full Text:

PDF

References


Shinohara MM, Nguyen J, Gardner J, Rosenbach M, Elenitsas R. The histopathologic spectrum of decorative tattoo complications. J Cutan Pathol. 2012;39:1110-8.

Ortiz AE, Alster TS. Rising concern over cosmetic tattoos. Dermatol Surg. 2012;38:424-9.

Sanghavi SA, Dongre AM, Khopkar US. Tattoo reactions-an epidemic on the surge: a report of 3 cases. Indian J Dermatol Venereol Leprol. 2013;79:231-4.

Wollina U, Cuyper C. Tattoo removal. In: Maibach H, Gorouhi F. editors. Evidence based Dermatology. 2nd edition. Shelton: PMPH-USA;2011:557-570.

Straetemans M, Katz LM, Belson M. Adverse reactions after permanent makeup procedures. N Engl J Med. 2007;356:2753.

Drage LA, Ecker PM, Orenstein R, Phillips PK, Edson RS. An outbreak of Mycobacterium chelonae infections in tattoos. J Am Acad Dermatol. 2010;62:501-6.

Kluger N. Acute complications of tattooing presenting in the ED. Am J Emerg Med. 2012;30:2055-63.

Jovanovic DL, Slavkovic JMR. Allergic contact dermatitis from temporary henna tattoo. J Dermatol. 2009;36(1):63-5.

Jacob SE, Castanedo MP, Blyumin ML. Inflammation in green (chromium) tattoos during patch testing. Dermatitis. 2008;19(5):33-4.

Garcovich S, Carbone T, Avitabile S, Nasorri F, Fucci N, Cavani A. Lichenoid red tattoo reaction: histological and immunological perspectives. Eur J Dermatol. 2012;22(1):93-6.

Patrizi A, Raone B, Savoia F. Tattoo-associated pseudolymphomatous reaction and its successful treatment with hydroxychloroquine. Acta Derm Venereol. 2009;89(3):327-8.

Sarma DP, Dentilinger RB, Forystek AM. Poorly differentiated squamous cell carcinoma arising in Tattooed skin. Case Rep Med. 2010;2010:431813.

Kluger N, Koljonen V. Tattoos, inks, and cancer. Lancet Oncol. 2012;13:161-8.

Pohl L, Kaiser K, Raulin C. Pitfalls and recommendations in cases of decorative tattoos with pigmented lesions: cases report and review of literature. JAMA Dermatol. 2013;149(9):1087-9.

Ross JR, Matava MJ. Tattoo-induced skin "burn" during magnetic resonance imaging in a professional football player: a case report. Sports Health. 2011;3:431-4.

Riml S, Larcher L, Grohmann M, Kompatscher P. Second-degree burn within a tattoo after intense-pulsed-light epilation. Photodermatol Photoimmunol Photomed. 2013;29:218-20.

Kluger N, Mathelier FP, Moguelet P. Scleroderma-like reaction restricted to the red parts of a tattoo. Acta Derm Venereol. 2009;89:95-6.

Weidman AI, Andrade R, Franks AG. Sarcoidosis, report of acase of sarcoid lesions in a tattoo and subsequent discovery of pulmonary sarcoidosis. Arch Dermatol. 1966;94:320-5.

Balfour E, Olhoffer I, Leffell D. Massive pseudoepitheliomatous hyperplasia: an unusual reaction to a tattoo. Am J Dermatopathol. 2003;25:338-40.

Matsika A, Srinivasan B, Gray JM, Galbraith CR. Tattoo pigment in axillary lymph node mimicking calcification of breast cancer. BMJ Case Rep. 2013.

Ortiz AE, Alster TS. Rising concern over cosmetic tattoos. Dermatol Surg. 2012;38:424-9.

Goldman L, Wilson RG, Hornby P, Meyer RG. Radiation from a Q-switched ruby laser. Effect of repeated impacts of power output of 10 megawatts on a tattoo of man. J Invest Dermatol. 1965;44:69-71.

Kent KM, Graber EM. Laser tattoo removal: a review. Dermatol Surg. 2012;38:1-13.

Klein A, Rittmann I, Hiller KA, Landthaler M, Bäumler W. An Internet-based survey on characteristics of laser tattoo removal and associated side effects. Lasers Med Sci. 2013;29:729-38.