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[Seborrheic keratosis erupting in a tattoo].

INTRODUCTION: Decorative tattoos have been associated with inflammatory reactions and transmission of infectious diseases. Cutaneous tumors have rarely been reported. CASE REPORT: We report the case of a 26-year-old man who presented eruptive seborrheic keratoses strictly localized on the area of a decorative tattoo. No other lesion was present anywhere else on the cutaneous surface. Three years later the lesions remained stable. COMMENTS: To our knowledge, this is the first report of eruptive seborrhelc keratoses on a tattoo. In our observation, the role of human papillomavirus contamination during tattoo procedure is discussed.

Adult↗

Effective treatment of permanent tattoos with combustible particles due to blast injuries with a V-shaped device.

Permanent tattooing due to blast injuries is a rare condition. Treatment with various different methods often yields unsatisfactory results. An innovative way to remove permanent traumatic tattoos is presented. A normal curettage blade is simply compressed with a pincer in order to create the new device. This V-shaped blade was used for surgical excision of the particles. No suture material or special dressing was used. Four patients with multiple explosive tattoos on the face were treated with the V-shaped knife. Due to the ease and speed of this method up to 300 particles were removed in one session. Histological analysis of the tissue samples showed deep dermal and subcutaneous particle location. At follow-up transient hypopigmentation but only minimal scarring was seen. Patients suffered less from itching, a chief complaint preoperatively, and aesthetic appearance of the facial skin was improved. In conclusion, treatment of traumatic tattoos with the V-shaped knife is effective, results in minimal scaring and restores the natural colour of the skin because the particle is completely removed. It is a promising method for treating multiple deep skin inclusions.

Adult↗

Bleomycin tattooing as a promising therapeutic modality in large keloids and hypertrophic scars.

BACKGROUND: Cryotherapy combined with intralesional triamcinolon injection is the most common traditional therapy for hypertrophic scars and keloids. The literature contains few articles on the use of bleomycin tattoo for treatment of these conditions. OBJECTIVE: This study compares the efficacy of bleomycin tattoo with that of cryotherapy combined with intralesional triamcinolon injection for the treatment of keloids and hypertrophic scars. MATERIALS AND METHODS: Forty-five patients with hypertrophic scars or keloids were randomly divided into two groups. Group A was treated with bleomycin tattoo, and group B, with cryotherapy combined with intralesional triamcinolon injection. There were four therapeutic sessions at 1-month intervals. All patients were followed for 3 months after the end of treatment. RESULTS: Therapeutic response in lesions less than 100 mm2 was higher than 88% in both groups, but in larger lesions, the therapeutic response to bleomycin was significantly better than cryotherapy combined with intralesional triamcinolon injection (p = .03). In group A, no relationship was observed between therapeutic response and lesion size (p = .58); however, in group B smaller lesions (< 100 mm2) displayed better therapeutic response (p = .007). CONCLUSIONS: Bleomycin tattoo may be more effective than cryotherapy combined with intralesional triamcinolon injection in treatment of larger keloids and hypertrophic scars (size > 100 mm2).

Adolescent↗

Trial of a novel endoscopic tattooing biopsy forceps on animal model.

AIM: To tattoo gastric mucosa with a novel medical device which could be used to monitor and follow-up gastric mucosal lesions. METHODS: Combining endoscopic biopsy with sclerotherapy injection, we designed a new device that could perform biopsy and injection simultaneously. We performed endoscopies on a pig by using a novel endoscope tattoo biopsy forceps for 15 mo. At the same time, we used two-step method combining sclerotherapy injection needle with endoscopic biopsy. The acuity, inflammation and duration of endoscopy were compared between two methods. RESULTS: Compared with the old two-step method, although the inflammation induced by our new device was similar, the duration of procedure was markedly decreased and the acuity of tattooing was better than the old two-step method. All characteristics of the novel device complied with national safety guidelines. Follow-up gastroscopy after 15 mo showed the stained site with injection of 1:100 0.5 mL of India ink was still markedly visible with little inflammatory reaction. CONCLUSION: Endoscopic tattooing biopsy forceps can be widely used in monitoring precancerous lesions. Its safety and effectiveness has been established in animals.

Animals↗

[Tattooing of the bronchial mucosa in patients with pneumoconiosis and dust bronchitis].

Medical examinations were performed of 138 pneumoconiosis (PC), 123 dust bronchitis (DB) cases and 28 pulmonary cases of non-occupational etiology. Fiber bronchoscopy with biopsy of bronchial mucosal tissue and, if necessary, transbronchial biopsy were performed in all the cases. Bronchial mucosa tattooing in persons exposed to different industrial aerosols did not depend on the forms of PC, DB and the diseases' stages. Nevertheless, it was established that, at more expressed stages of the disease and in case with complications (anthraco-tuberculosis), tattooing of the bronchial tree was more developed. In 92.3% cases, tattooing was formed in persons exposed to industrial aerosols containing more than 10% free silicon deoxide. On the tissue level, the morphologic substrate of the tattooing was lymphatic nodes obturating the coniophages and the coniotic infiltration of the bronchial mucosa connective tissue. Anthraco-tuberculosis induced specific inflammation contributed to the infiltration process due to the lymphodynamic disorders caused by lymphadenopathy.

Adult↗

Salabrasion of tattoos. A correlation of the clinical and histological results.

Twenty-six tattoos were treated by salabrasion. The salt was left on the abraded surface from zero to 24 hours. The percentage of residual pigment varied from 50%, when the salt was removed immediately after salabrasion, to 5%, when the salt was left in place for over 12 hours. When the salt was left on for variable periods, some degree of scarring and hypopigmentation occurred in 79% and in 59% of the tattoos, respectively. When the salt was removed immediately after salabrasion, 29% of the tattoos showed scarring and 29% showed hypopigmentation. Our results show that the best method is to remove the salt immediately after salabrasion, but that this form of therapy should only be done on those lesions where the eventual cosmetic result is not important.

Cicatrix↗

Development of sarcoidosis in cosmetic tattoos.

BACKGROUND: The development of granulomatous lesions within tattoos is a well-recognized occurrence in individuals with sarcoidosis. The characteristic histopathological finding of sarcoidosis is the presence of noncaseating granulomas; however, similar histopathogical findings may be seen in foreign body granulomas. Several reports have challenged the assertion that the presence of foreign material within sarcoidal granulomas is incompatible with a diagnosis of sarcoidosis. OBSERVATIONS: We describe a patient who had multiple linearly arranged papules along her eyebrows and the vermillion border of her upper lip. She had had cosmetic tattooing performed on these areas 3 year prior to presentation. Histopathologic examination revealed sarcoidal granulomas, polarizable foreign material, and pigment granules. Hilar adenopathy was noted on a chest radiograph. After 4 months of treatment with a midpotency topical steroid and doxycycline, she experienced complete clearance of her cutaneous lesions and normalization of chest x-ray film findings. CONCLUSIONS: This case demonstrates a unique adverse result after cosmetic tattooing and highlights the concept that granulomatous histopathologic findings containing foreign material should not be an exclusionary criterion for the diagnosis of sarcoidosis. In this setting, further investigation for the presence of systemic disease is indicated.

Administration, Topical↗

Successful treatment of treatment-resistant laser-induced pigment darkening of a cosmetic tattoo.

BACKGROUND AND OBJECTIVE: Cosmetic tattoo removal has a reported risk of immediate pigment darkening when treated with a high energy, nanosecond pulsed-laser system. Surgical treatment options for this reaction are limited and carry significant risk of scarring and permanent pigment alterations. This report describes the response of a resistant Q-switched ruby laser-induced cosmetic tattoo ink darkening to multiple treatments with the Q-switched alexandrite laser and Q-switch Nd:YAG laser and textural improvement with the UltraPulse CO(2) laser. STUDY DESIGN/MATERIALS AND METHODS: A woman with Q-switched ruby laser-induced pigment darkening of a cosmetic tattoo of the upper lip resistant to four further treatments with the ruby laser and two chemical peels received a total of 26 treatments with the Q-switched alexandrite and Nd:YAG lasers and a single treatment with the UltraPulse CO(2) laser, most treatments being done at monthly intervals. RESULTS: Treatment of the affected areas with the Q-switched alexandrite and Nd:YAG lasers resulted in complete clearing of the pigment without scarring, but revealed some preexisting textural changes. Use of the UltraPulse CO(2) laser smoothed the surface irregularities. CONCLUSION: The Q-switched pigment lasers are a useful modality for treating this pigment darkening reaction. As in this case, multiple treatment sessions with the laser may be necessary but the pigment can be expected to clear eventually without scarring. Any textural changes may be blended with the UltraPulse CO(2) laser with further improvement.

Adult↗

Magnetic resonance imaging and permanent cosmetics (tattoos): survey of complications and adverse events.

PURPOSE: To use a survey to determine the incidence of complications and adverse events in individuals with permanent cosmetics (e.g., tattooed eyeliner, eyebrows, lips, cheeks, etc.) who underwent magnetic resonance (MR) imaging. MATERIALS AND METHODS: A questionnaire was distributed to clients of cosmetic tattoo technicians. This survey asked study subjects for demographic data, information about their tattoos, and for their experiences during MR imaging procedures. RESULTS: Data obtained from 1032 surveys were tabulated. One hundred thirty-five (13.1%) study subjects underwent MR imaging after having permanent cosmetics applied. Of these, only two individuals (1.5%) experienced problems associated with MR imaging. One subject reported a sensation of "slight tingling" and the other subject reported a sensation of "burning"; both sensations were transient in nature. CONCLUSION: Based on these findings and information in the peer-reviewed literature, it appears that MR imaging may be performed in patients with permanent cosmetics without any serious soft tissue reactions or adverse events. Therefore, the presence of permanent cosmetics should not prevent a patient from undergoing MR imaging.

Artifacts↗

Factitious microcalcifications in breast biopsy material: laboratory-induced error by use of tattoo powder for specimen mammography.

A xeromammogram led to the surgical excision of a calcified breast lesion on a 66-year-old female. Before specimen mammography was performed, the excised tissue was oriented with tattoo pigment. The specimen mammogram then revealed multiple calcifications caused by unsuspected radio-opaque material in the tattoo pigment, and the original calcifications were obscured. This case demonstrates the hazards involved utilizing tattoo powders for orienting xeromammographically discovered specimens.

Aged↗

Clinical, histologic, and ultrastructural evaluation of tattoos treated with three laser systems.

We examined the response of tattoo pigments treated with three commercially available lasers: Q-switched ruby, Q-Switched neodynium:yttrium,aluminum,garnet (Nd:YAG), and the alexandrite. Tattoos applied to hairless guinea pigs and treated with the aforementioned lasers were evaluated clinically, histologically, and ultrastructurally. Clinical evaluation showed red brown, dark brown, and orange pigment responded best to the Nd:YAG laser (1064 nm). The alexandrite laser was most effective for removing blue and green pigment, the Q-switched ruby laser was most effective for removing purple and violet pigment, and the Nd:YAG laser (532 nm) removed red pigment the best. Black pigment was lightened equally with the Nd:YAG laser (1064 nm) and (532 nm) and the alexandrite laser (755 nm). No clinical scarring was observed; however, some colors turned black after treatment. Histologic and ultrastructural examination showed epidermal and dermal damage to be most evident after treatment with the Nd:YAG laser. Our study shows that certain tattoo pigments respond better to different laser systems.

Aluminum Oxide↗

[Delayed type allergic reaction to red azo dye in tattooing].

Allergic reactions in tattoos are comparatively rare. In most cases the reactions are caused by different red pigments. While in the past these reactions have been ascribed to mercury salts (cinnebar) and cadmium sulphide, now synthetic inorganic azo dyes have also been found to be responsible for such reactions. A 42-year-old man presented with an allergic reaction in the red parts of his tattoos. Histologically a chronic granulomatous, partly fibrous inflammation with transfollicular elimination of pigment granules was found. Spontaneous regression in a part of the inflammatory reaction was observed, simultaneously with depigmentation and scarring of the overlying skin. The pigment used for tattooing was found to be an aromatic azo derivative. In addition to a positive cutaneous reaction to the dye, the patient also showed a positive patch test to Napthol AS, used for the coupling of different dyes in the textile industry.

Adult↗

[Reaction patterns to cutaneous particulate and ornamental tattoos].

Particulate matter incorporated into the skin of former miners was compared to ornamental tattoos with regard to composition and cutaneous reaction pattern. The specimens were examined histologically and immunohistochemically followed by scanning electron microscopy and element analysis. In the skin biopsies containing dirt particles, silicon and aluminium were regularly found and the particles were positively birefringent under the light microscope. Even years after the initial foreign particle incorporation strong reactions against quartz-containing substances deposited perivascularly and perifollicularly continued to take place. Reactions ranged from strong macrophage activation to pre-granulomatous changes. Anthracotic pigment was demonstrated in all layers of the dermis depending on the degree of traumatic insult and the colour pigments of the ornamental tattoos showed a variable spectra of elements depending on the type of dye used. Fibrous reactions were only discrete, however, strong macrophage activation and sometimes capillary proliferation as well as non-specific lymphocytic infiltration could still be confirmed even decades after the initial incorporation. In conclusion, the cutaneous incorporation of ornamental tattoo dyes and accidental dirt particles is not an inert process. Even years later, non-specific macrophage activation as well as discrete inflammatory changes in an attempt to degrade the foreign material can still be documented. A clear correlation between subcutaneous incorporated quartz particles and progressive systemic sclerosis was not found in this study.

Humans↗

Corneal tattooing for the treatment of debilitating glare in a child with traumatic iris loss.

PURPOSE: To report the cosmetic and therapeutic use of corneal tattooing for a child with sectoral traumatic corneal scarring and symptomatic glare from sectoral traumatic iris loss. DESIGN: Interventional case report. METHODS: A six-year-old girl underwent corneal tattooing (platinum chloride reduced by hydrazine) in the relevant scarred corneal sector. RESULTS: Six months after the procedure, the child enjoyed a more normal corneal appearance and no longer suffered from glare. Postoperative epithelial healing, however, was slow and required vigilance. CONCLUSIONS: Corneal tattooing can allow both cosmetic and therapeutic benefit when indicated in a child. However, postoperative healing may require management when using platinum chloride reduced by hydrazine.

Child↗

Nipple-areola reconstruction by tattooing and nipple sharing.

In a reconstructed breast the nipple-areola complex can be restored by various techniques, most of which are complicated and may leave residual scarring at the donor site. The primary intradermal tattooing and nipple sharing technique for nipple-areola reconstruction is simple and can be done under local anaesthesia. We present our experience of 31 patients who had 32 areolar reconstructions using intradermal tattooing (one patient had bilateral breast reconstruction). Seventeen patients had a nipple reconstruction by the nipple sharing technique. At follow-up of 2 months to 4 years, 4 patients have required further tattooing because of fading of the pigment and 1 patient has a gross areolar colour mismatch. There have been no nipple graft failures and the reconstructed nipples have adequate projection.

Adult↗

An outbreak of hepatitis B from tattooing.

An outbreak of 34 cases of hepatitis B not all of them notified, is described. 31 was tattooed by one artist; 3 were secondary infections. All primary infections occurred in males aged 16-28 years. Several defects in hygiene in the tattooing procedure were noticed. Recommendations are made for the licensing and routine inspection of all tattoo parlours.

Adolescent↗

Pseudolymphomatous reaction to tattoos. Report of three cases.

Three cases with pseudolymphomatous hypersensitivity reaction to tattoo pigment are described. One of the cases showed histologic features of Spiegler-Fendt pseudolymphoma. Awareness of this type of reaction to tattoo pigment can help prevent erroneous diagnosis of lymphoma. Several published reports are cited in which pseudolymphomatous reaction to tattoo pigment was erroneously diagnosed as lymphoma.

Adult↗

Tretinoin in the removal of eyeliner tattoo.

Eyelid tattooing is a commonly performed procedure. For at least 100 years, it has been performed by medical and nonmedical professionals. Complications can occur; the main one is improperly placed pigment. To date, the most frequently reported methods to remove eyeliner tattoos have been laser treatments or surgical correction. We observed a case in which tretinoin was used successfully in the removal of an eyelid tattoo.

Adult↗