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Photoessay: Tattoo - Related Skin Lesions

Dr Sampurna Roy MD   

 

                                   

The term tattooing is derived from "tattau", a Tahitian word which translates essentially as "to mark" and is a process of implantation of permanent pigment granules in the skin. 

It may be done intentionally for cosmetic purposes (decorative tattoos and permanent makeup) or therapeutic purposes (medical tattoos), or introduced accidentally (traumatic tattoos), in case of abraded skin injuries.

Khunger N, Molpariya A, Khunger A. Complications of Tattoos and Tattoo Removal: Stop and Think Before you ink. Journal of Cutaneous and Aesthetic Surgery. 2015;8(1):30-36. 

 

Numerous potential complications secondary to tattoo placement have been reported in literature.

Tattoo reactions can be divided into three main categories: inflammatory, infectious, and neoplastic.

Inflammatory manifestations include focal oedema, pruritus, papules, or nodules at the tattoo site.

Histologically they can be classified as lichenoid, eczematoid, foreign body granulomatous, and sarcoidal.

Less commonly, psoriasiform, morpheaform, and vasculitic reaction have also been reported.

The infectious reaction can be generally distinguished in bacterial,viral or mycotic and they can appear as superficial or with deep skin involvement.

Rare but possible reactions are represented by pseudoepitheliomatous hyperplasia and pseudolymphoma.

They are not considered as real premalignant conditions.

The neoplastic complication described within tattoo pigments includes keratoacanthoma, squamous cell and basal cell carcinoma, leiomyosarcoma, and melanoma.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

       

Foreign body granulomatous reaction on a black tattoo and relative histology with granulomatous depositions of exogenous pigment in the background of granulomatous-productive inflammation of the dermal stroma.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

 

 

     

Lichenoid reaction on a black tattoo and relative histology with a widespread vacuolar basal epidermic degeneration with a deep dermal lymphohistiocytic infiltrate into a lichenoid pattern, associated with deposition of exogenous pigment.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

 

 

 

(a) Pseudoepitheliomatous hyperplasia on a red tattoo and relative histology with epidermal pseudoepitheliomatous hyperplasia and follicular hyperkeratosis ;

(b) the part indicated by the arrow shows an inflammatory infiltrate in the dermis, composed of lymphocytes and plasma cells and dermal exogenous pigment deposition.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

 

 

 

      

Pseudolymphomatous reaction on a red tattoo and relative histology with the presence of red colour exogenous pigment in the background of a reactive lymphoid hyperplasia in the superficial and medium dermis.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

 

 

    

Pseudolymphomatous reaction on a black tattoo and relative histology with the presence of black colour exogenous pigment in the background of a reactive lymphoid hyperplasia in the superficial and medium dermis.

Bassi A, Campolmi P, Cannarozzo G, et al. Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment. BioMed Research International. 2014;2014:354608. 

 


 

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