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Public health 3: Legal regulation of tattooing and body art.

District nurse Mandy Grey is currently treating a thirteen year old girl who has a seriously infected tattoo on her buttock and infected tongue and nipple piercing all of which were performed at a local tattoo parlour. The teenager wanted the tattoo and piercing as all her friends have had similar body art and she felt pressured into having the same. Sister Grey wonders how this ever popular and increasingly intimate form of bodily adornment is regulated.

Adolescent↗

College students with tattoos and piercings: motives, family experiences, personality factors, and perception by others.

The motives, family experiences, and personality characteristics of 341 college students with and without tattoos or piercings were studied. Participants completed Lippa's 1991 measures of the Big Five personality factors, a shortened version of the Body Cathexis Scale, a series of questions about their childhood experiences, and questions about risk-taking behaviors. In addition, reasons to have or not have body modifications and the perceptions of people with body modifications were investigated. Of the 116 men and 186 women, 25% and 33%, respectively, had at least one tattoo or body piercing. There were very few differences in the childhood experiences or personality characteristics of people with or without body modifications. Although people with body modifications did not differ from people without modifications on the Big Five personality measures, people without modifications perceived people with modifications as much different from themselves on these measures. These results indicate that tattoos and piercings in college students are associated with significantly more risk-taking behavior, greater use of alcohol and marijuana, and less social conformity. However, the traditional stereotype that body modifications are indicators of social or personal pathology does not describe contemporary college students.

Adolescent↗

Tattoos and ratings of personal characteristics.

High school and university students viewed a photograph of one woman either with or without a visible tattoo on her upper arm. They rated the woman on 13 personal characteristics (fashionable, athletic, attractive, caring, creative, determined, motivated, honest, generous, mysterious, religious, intelligent, artistic). Analyses showed ratings of the model with the tattoo were statistically significantly lower (more negative) on 9 of the 13 personal characteristics. Ratings were not associated with whether the participants had or did not have tattoos themselves. Implications for research are discussed, including the need to explore the conditions under which negative attitudes may be translated into negative behaviors.

Adolescent↗

Age, sex, education, religion, and perception of tattoos.

Tattooing has become more acceptable in the mainstream American culture in recent years. Based on a survey with face-to-face interviews of 335 nontattooed adults randomly selected from a city with a population of 444,000, this study explored the relationship of individuals' demographic variables, attitudes toward religion, and their perceptions of tattoos. The hierarchical multiple regression analysis showed that age and attitude toward religion were associated with individuals' perception of tattoos.

Adult↗

Urticaria in a tattooed patient.

We present a case of urticaria in a tattooed patient due to hypersensitivity to the cobalt chloride contained in the blue ink used for tattoo. The patch test with the series of International Contact Dermatitis Research Group was positive only for chloride cobalt. Cobalt is believed to be responsible for contact urticaria through a non-immunological mechanism. On reviewing the literature we have found no report of contact urticaria to cobalt in tattooed patients.

Adult↗

[Contact dermatitis caused by labile henna skin tattoo].

BACKGROUND: Contact dermatitis to henna are rarely reported. Most of the time, they are related to additives, especially scented oils or paraphenylene diamine. This latter substance is added to shorten the time of application and to enhance the darkness of the color. We report one case of an allergic contact dermatitis to henna skin tattoo, probably related to a paraphenylene diamine derivative. CASE REPORT: A 25-year-old woman developed an allergic contact dermatitis at the site of application of two henna skin tattoos on her right arm. She never dyed her hair and wore dark clothing without problems. Epicutaneous tests were positive for henna paste, paraphenylene diamine, N-isopropyl-N'phenylparaphenylene diamine and five chemical dyes, probably related to cross- reactions between paraphenylene diamine and these dyes. Epicutaneous test with henna powder was negative, confirming the absence of allergy to henna. Fluorescence analysis detected the presence of a primary amine in henna paste but high performance liquid chromatography analysis did not reveal the presence of paraphenylene diamine or any suspect dye. An another allergen, related compound of paraphenylene diamine, was probably present but we failed to identify it with precision. DISCUSSION: Labile henna skin tattoos are in fashion at the moment in western European countries. They can be a secrete source of paraphenylene diamine, or one of its related compounds, sensitization.

Adult↗

A tattoo and localized lymphadenopathy: a case report.

We report the case of a left inguinal lymph node enlargement in a young man. A tattoo was present in close proximity to the lymph node and had preceded its enlargement by several years. The lymph node was removed surgically, and pathologic examination showed it to contain dark pigment material characteristic of a tattoo. The clinical significance of this finding is discussed, and the relationship of tattoo lymphadenopathy to inflammatory skin reactions and to dermatopathic lymphadenopathy is considered.

Adult↗

Body piercing, tattooing, self-esteem, and body investment in adolescent girls.

Postmodern perspectives of body piercing and tattooing interpret these as signifiers of the self and attempts to attain mastery and control over the body in an age of increasing alienation. In this exploratory study, 79 adolescent females, ages 15 to 18 (M = 16.08, SD = 1.36), completed the Coopersmith Self-Esteem Inventory (SEI; Coopersmith, 1981), the Beck Depression Inventory (BDI; Beck, 1978), the Body Investment Scale (BIS; Orbach & Mikulincer, 1998), and the State-Trait Anger Expression Inventory (STAXI-2; Spielberger, 1996). Analyses revealed that body piercings and tattoos were significantly correlated with trait anger (Angry Reaction subscale scores). A multiple regression analysis indicated that three of the dependent variables (Trait Anger-Reaction, BDI, and Feeling subscale of the BIS) were predictors of the total number of body piercings and tattoos.

Adolescent↗

Appearance and culture: oral pathology associated with certain "fashions" (tattoos, piercings, etc.).

Humans are characterized by a compulsive tendency to distinguish themselves from the rest: differences in clothes, hairstyle or "decorative" details are used to this effect, based on highly diverse criteria. Such differentiating practices may be aimed at identification with a certain ideological group, for example, or with a concrete "fashion", and involve the use of jewelry, clothes, unusual attire, hairstyles, mutilations, etc. In this context, the present review addresses certain aspects of mutilation practices from both the general and specifically dental perspectives. Mutations imply permanent or lasting sectioning or lesions of a part of the body, and comprise skeletal deforming, dental mutilations, circumcision, ablation of the clitoris, scarification, tattoos, and perforations (particularly of the soft tissues). In this sense, tattoos and perforations or piercings are popular -- particularly among adolescents. This trend may be interpreted as a form of communication, identity expression, or as a type of body cult (i.e., so-called "body art"). Such mutilating practices reflect different motivations including fashion, rebelliousness, differentiation, sexual motives, the remembering of events, physical sensations, and ethnic or tribal influences. However, these practices can cause complications such as infections, laceration and soft and hard tissue damage, hypersensitivity reactions and other alterations of variable severity. Under these premises, questions are raised concerning the competence of those who perform these mutilations, the preventive measures adopted, and the legal conditions under which tattoos and piercings are made in our society.

Adolescent↗

[Forum: dermopigmentation or medical tattooing. Needles and ink].

Tattooing has been performed since ancient times. It has survived religions, development of education, wars and all forms of repression. Tattooing has gained a new lease of life at a time when this practice appeared to be dying out; why? In reality, tattooing corresponds to a need to be different, to make oneself attractive and to see oneself as a unique being and the age of uniformity in which we live is a very important factor for requests for dermography. Techniques have progressed together with conditions of asepsis and sterilisation. Until the profession of tattooist is officially recognised, it will always be associated with the idea of sordid techniques in makeshift quarters. The very survival of this artistic profession requires serious training and standards of hygiene. Failure to recognise this profession would result in its prohibition in the short-term, leading to clandestine activity in which standards would obviously not be respected.

Art↗

Cutaneous and pulmonary sarcoidosis in association with tattoos.

Sarcoidosis encompasses a heterogeneous spectrum of clinical presentations, including sarcoidosis in association with tattoos. We report the development of cutaneous and pulmonary sarcoidosis in a patient with long-standing eyebrow tattoos whose cutaneous sarcoidosis almost completely resolved when treated with tacrolimus 0.1% ointment. A 70-year-old woman with a 3-year history of an erythematous eruption circumscribing her eyebrow tattoos presented with a chronic, nonproductive cough of 8 months' duration. Skin biopsy results demonstrated naked tubercles consistent with sarcoidosis. Results of radiographs and a computed tomography scan of the chest revealed multiple pulmonary nodules with mediastinal and hilar adenopathy. The results of transbronchial biopsy were consistent with the diagnosis of pulmonary sarcoidosis. Initial treatment with oral prednisone only improved the pulmonary sarcoidosis. The cutaneous sarcoidosis almost completely resolved after the addition of tacrolimus 0.1% ointment.

Aged↗

Tattoo designs among drug abusers.

Forty-one males with drug abuse who had tattoos with designs related to drug use were selected from a larger sample of tattooed males in forensic psychiatric wards, prisons and military recruitment centers during the period 1986-2000 in the former Soviet Union. Two-thirds of the tattoo images were related to a specific drug, some served to hide signs of repeated drug use, others to identify ideal sites for injection. Knowledge of these details may be helpful to clinicians, although images may be influenced by current trends.

Adolescent↗

Contact dermatitis to temporary tattoo.

The development of contact hypersensitivity to temporary tattoos has been on an increase all over the world. Skin painting with henna is a traditional practice in the Moslems and Hindu, and has recently been increasingly used in western countries. Black henna is obtained by adding paraphenylenediamine to the natural occurring henna. The risk of sensitization increases with the length of contact and increase of the concentration. A case is presented of an 11-year-old boy who developed a severe reaction in the form of redness and edema accompanied by pruritus on the day following the application of a temporary tattoo. A year before, the patient had also developed a skin reaction following temporary tattooing, which had not been recognized as a contact dermatitis. Patch testing was positive for paraphenylenediamine and thiuram compounds. The patient was treated with medium-strength corticosteroids.

Child↗

[Laser therapy for tattoos].

Tattoos are produced by bringing colorants of various compositions into the skin. The ingredients of these colorants are not declared and are not subjected to pharmacological and toxicological tests. Ultrashort and high intensity laser pulses are used to remove tattoos. The laser beam breaks up the pigments embedded in the skin so that they can be transported away from the site. Clinically, the pigment becomes less intense or completely disappears. The success of the laser treatment essentially depends on the pigments used in the tattoo and on how deeply the pigments are embedded in the skin. The laser treatment is slightly painful and has a low rate of permanent side effects.

Coloring Agents↗

Foreign body epithelioid granuloma after cosmetic eyebrow tattooing.

We describe two patients with epithelioid granulomatous inflammation on the eyebrows after undergoing cosmetic eyebrow tattooing. We tried to analyze the causative elements from biopsy specimens and tattoo inks with x-ray microanalysis. We suggest that granuloma caused by cosmetic eyebrow tattooing is a complication worthy of mention.

Adult↗

Tattooing in reconstruction of the nipple and areola: a new method.

In order to produce the characteristic color of the nipple-areola complex and in unilateral reconstructions to match the other side, a modified tattooing method has been introduced. The quite different requirements between reconstruction and ornamental studio tattooing can only be satisfied by different techniques. For the first time, pigment particles have been suspended in a gel rather than adsorbed on an opaque mineral. Our porcine study has shown how the pigment is distributed in the dermis without penetration of the gel particles. The first 16 of the authors' 29 patients have been reviewed with an analysis of their appearance. Using this new method, a third achieved a completely natural appearance and two-thirds were judged to be intermediate, compared with an unnatural, although sometimes acceptable, result in all the earlier conventional tattoos.

Breast↗

[Sarcoid granuloma in green tattooing].

The case report is presented of a 34-year old man with the sudden appearance of multiple granulomas at the site of green tattoo markings which had been undertaken 8 years previously. Unusual was his case history of an anaphylactic reaction after the ingestion of green pistachio nuts. A non-immunological food intolerance without cross-reaction to the dye of the green tattoo namely phthalocyanine, was detected. Aerosil, colloidal silica, was found to be the trigger substance; it was present exclusively in the green dye, and was responsible for the patient's sarcoid reaction. Excision of the green tattoos employing pedicle flaps was successful. At the latest follow-up examination no features of sarcoidosis were detected.

Adult↗

[Removal of tattoos with the Nd:YAG laser].

Irradiation of 20 tattoos using the Q-switched Nd:YAG laser (energy density 3-5 J/cm2, asymmetrical pulse shape with 50% energy output in 18 ns, spot size 3 mm in diameter) gave the impression that black ink tattoos can be completely removed without scarring. Some patients needed several treatments. The results continued to improve even some months after the irradiation. In preliminary experiments on excised tattooed and untattooed skin the non-Q-switched Nd:YAG laser had distinct burning effects. It was therefore not tested in patients. The results of chemical, physical, and histological examinations are discussed with special reference to toxic side-effects that might be induced by laser irradiation.

Humans↗