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[Dirt tattooing following an explosion in a chemistry class].

Traumatic tattooing following an explosion can generally be removed by rubbing with a hard-bristle handbrush within 48 h after the accident occurs. This measure failed, however, in the case of a pupil with extensively dispersed granular material in the face. The patient had mixed approximately 5 g of potassium permanganate and red phosphorus together during a chemistry lesson (!), thereby causing an explosion. A conservative treatment of applying compresses moistened with a sodium bicarbonate solution led to healing without scars.

Adolescent↗

An analytical electron microscopic study of a corneal tattoo.

A case of corneal tattoo was studied histologically, and by electron microscopy. Most of the electron dense granules were seen in keratocytes, either singly or in clumps; some were found between collagen fibrils. Platinum was localized in the granules by means of x-ray microanalysis.

Adolescent↗

[On the treatment of tattoos by argon laser (author's transl)].

Different laser systems have different effects on the human skin. During the treatment of tattoos the CO2 laser abrades thermically the skin in layers of 0,1-0,2 mm. The argon laser, however, is semiselectively absorbed by the dermal pigments which are vaporized and expelled through the rupturing epidermis. Remaining pigments are eliminated by the subsequent inflammatory reaction. The argon laser offers a feasible alternative to common methods with several useful advantages.

Humans↗

Reactions to manganese and cadmium in tattoos.

Concomitant allergic reactions to manganese and cadmium sulfide developed in a patient in tattooed areas. Although the reaction to cadmium was elicited by sunlight, attempts to reproduce it with artificial long-wave ultraviolet light were unsuccessful.

Adult↗

Mechanized keratomicropigmentation: corneal tattooing with the blepharopigmentor.

BACKGROUND AND OBJECTIVE: A mechanized micropigmentor with a triple prong tip was used to tattoo two corneas for cosmetically unacceptable blemishes. PATIENTS AND METHODS: Two adult patients with cosmetically disfiguring corneal blemishes in sightless eyes requested cosmetic improvement. With a mechanized micropigmentor, appropriate pigment was directly inoculated through the epithelium. RESULTS: After 2 and 3 years of follow-up, respectively, there have been no complications and there has been minimal fading. CONCLUSION: This mechanical device facilitates many more penetrations to introduce pigment, with a more uniform depth than can be achieved by freehand methods.

Adult↗

Systemic sarcoidosis presenting in the black dye of a tattoo.

Sarcoidosis is an idiopathic granulomatous disease with many cutaneous manifestations and a known predilection for scars and areas of previous trauma. We report the first case of systemic sarcoidosis presenting in only the black dye of a tattoo. The skin manifestations of sarcoidosis and the histologic differential diagnosis of granulomas are reviewed.

Adult↗

Posterior wall gastric leiomyoma: endoscopic tattooing facilitates laparoscopic resection.

OBJECTIVE: To demonstrate the application of tattooing for the intraoperative localization of posterior wall gastric leiomyoma during laparoscopic resection. The preoperative injection of Indian ink in the tumor-bearing area of the posterior gastric wall eliminates the need to perform anterior wall gastrostomy or intraoperative upper endoscopic tumor localization. METHODS: A patient with posterior wall gastric leiomyoma was marked with Indian ink during preoperative upper endoscopy. The dye was visualized intraoperatively facilitating wedge resection of the tumor-bearing area with the Endo GIA. RESULTS: The patient had an uneventful surgery and recovery. Complete excision of the tumor was accomplished. CONCLUSION: The preoperative endoscopic marking of gastric lesions, facilitates the intraoperative localization and resection of these lesions.

Follow-Up Studies↗

[Removal of dirt tattooing with Q-switched laser].

In present times treatment of traumatic tattoos with Q-switched laser systems is an alternative to conventional therapy. In our study, 19 patients were treated with the Q-switched ruby laser, including 4 patients with explosive trauma and 2 after pointed pencil penetration. One patient was treated with the Q-switched Nd:YAG-laser, while we tried both systems on another one. Pigmentation after abrasive trauma is easily removed or improved. Deeper penetration of foreign bodies demands more intensive and more frequent therapy. Immediate removal of foreign bodies after an accident is the best treatment.

Adolescent↗

Amalgam pigmentation (amalgam tattoo) of the oral mucosa. A clinicopathologic study of 268 cases.

A series of 268 cases of amalgam tattoo is analyzed both clinically and histologically. The most common location was the gingiva and alveolar mucosa, followed by the buccal mucosa. Histologically, the amalgam was present in the tissues as discrete, fine, dark granules and as irregular solid fragments. The dark granules were arranged mainly along collagen bundles and around blood vessels. They were also associated with the walls of blood vessels, nerve sheaths, elastic fibers, basement membranes of mucosal epithelium, striated muscle fibers, and acini of minor salivary glands. Dark granules were also present intracellularly within macrophages, multinucleated giant cells, endothelial cells, and fibroblasts. Although in 45% of the cases there was no tissue reaction to the amalgam, in 17% there was a macrophagic reaction and in 38% there was a chronic inflammatory response, usually in the form of a foreign body granuloma, with multinucleated giant cells of the foreign body and Langhans types. Asteroid bodies were also found in some of the foreign body giant cells.

Adolescent↗

Treatment of traumatic tattoos with various sterile brushes.

BACKGROUND: Various types of brushes are efficient for the removal of foreign material accidentally projected into the skin by explosive or abrasive trauma. OBJECTIVE: To evaluate how different times between injury and treatment influenced esthetic results, we retrospectively evaluated 14 patients subjected to the brushing technique. METHODS: Two groups were identified. Group I had been treated within 24 hours of injury. In group II debridement had been performed later. RESULTS: Cosmetic results were strikingly better in group I. CONCLUSION: Our results demonstrate that debridement of traumatic tattoos should be carried out as soon as possible to achieve favorable cosmetic results.

Adult↗

Forensic value of gunpowder tattooing in identification of multiple entrance wounds from one bullet.

Multiple entrance gunshot wounds can give useful information in forensic evaluation of deaths from homicide and suicide. Although the presence of multiple entrance gunshot wounds does not absolutely exclude the possibility of suicide, they are important to the forensic investigators and pathologists in cases of assault, attempted homicide and suicide as they provide important clues for determination of number of shots fired and direction of firing. We present a case of 16 years of young woman who was shot to death by her husband. External examination revealed an entrance wound with semi-lunar shot residue at the dorsal side of her left hand at 5th metacarpus, and exit wound on the hypothenar muscle. There was also a second wound entrance located on her left zygoma. Direction of the bullet was downward traveling from left-to-right. Initially it was thought that there were two close shots, but when her left hand was placed over the malar area her face, it was determined that the gunshot powder tattoos were completing the nature of a single shot from a close distance. Crime scene investigation revealed only one cartridge casing. The autopsy and radiography findings showed that the bullet was entered from dorsal site of the left hand exiting from the palm and re-entering from the zygomatic region, hit the base of the skull, and remained in the soft tissue of the right mandible after passing the soft palate. The bullet was caused an incomplete laceration of the right internal arteria carotid and she died of internal and external bleeding. Detailed investigation of gunshot residues can provide important information for clarification of close distance gunshot wounding. We present this case due to its interesting nature, and to highlight the importance of detailed investigation of the gun powder residues in cases with multiple entry wounds.

Adolescent↗

Lichen aureus: a hemosiderin tattoo associated with perforator vein incompetence.

We present evidence that lichen aureus results from extravasation of red blood cells into the dermis caused by incompetence of an underlying perforator vein. The sudden appearance of the lesion suggests a "blow out" of the microvasculature of the lower dermis caused by failure of the valves in the perforator vein. This incompetence of the perforator vein induces a permanent reversal in normal blood flow. The consequent continuous high pressure in the cutaneous microvasculature is responsible for long-term leakage of red blood cells. Digestion of the extravasated red cells by macrophages leaves an "auto-tattoo" of insoluble hemosiderin granules, which produce the distinctive golden or burnt orange color of lichen aureus.

Adult↗

"Tooth worms", poverty tattoos and dental care conflicts in Northeast Brazil.

While medical anthropologists have studied doctor-patient clinical conflicts during the last 25-30 years, dentist-patient communication clashes have received scant attention to date. Besides structural barriers and power inequities, such conceptual differences further dehumanize dental care and lower service quality. Potential for dentist-patient discordance is greater in developing regions--such as Northeast Brazil--where there exists a wider socio-economic gap between professionals and laypersons. A critical anthropological evaluation of oral health services quality is undertaken in two rural communities in Ceará, Brazil where the PAHO-inspired Local Oral Health Inversion of Attention Program was implemented in 1994. This 6-month qualitative field study utilized ethnographic interviews with key informants, participant-observation and projective techniques to probe professionals' and patients' explanatory models (EMs) of oral health. Despite the recent expansion of services into rural regions, the authors conclude that the quality of dental care remains problematic. Patients' culturally constructed EMs of teeth rotted (estraga) by "tooth worms" (lagartas) differ substantively from dentists' model of dental decay by Streptococcus mutans. "Exploding chins" (queixo estourado), "spoiled, rotting teeth" (dente pĵdi) and "false plates" or teeth (chapas) tattoo and stigmatize the poor, reinforcing gross class inequities. Dentists' dominant discourse largely ignores lay logic, ridicules popular practices and de-legitimates, even castigates, popular healers despite their pivotal role in primary oral health care. Poor parents are not only barred from clinics but are blamed for children's rotten teeth. In sum, universal access to dental care is more a myth (even nightmare) than a reality. Dentists all too often "avert"--not "invert"--attention from poor Brazilian patients. In order to improve oral health in this setting, both "societal decay" and bacteria-laden plaque deposits must be removed.

Attitude to Health↗

The use of elemental microanalysis in verification of the composition of presumptive amalgam tattoo.

Routine histochemistry, special stains, and energy dispersive x-ray microanalysis (EDX) were used to analyze 15 cases of presumptive amalgam tattoo. Histologically, the fine, spherical, golden brown granules of amalgam were remarkably similar to hemosiderin and melanin granules, and routine and special stains were not always reliable in differentiating one from the others. EDX provided a simple, fast, inexpensive, and reliable method for identifying the precise elemental composition of the pigmented material.

Connective Tissue↗

Microsurgery in the prevention of traumatic tattoos.

We were able to remove most of the foreign body particles from a fresh wound caused by a gunpowder blast to the face, using microsurgical techniques. This prevented a subsequent serious dirt tattoo.

Blast Injuries↗

The use of microsurgical planing to treat traumatic tattoos.

A traumatic tattoo results from an abrasion in which dirt, carbon, tar, asphalt, or other particles have become embedded beneath the superficial layer of the dermis. These embedded particles are difficult to remove completely. Under a microscope, rectangular epidermal and upper dermal grids including these pigments are made, and each section of the grid is removed. The microsurgical planing technique has the following advantages: it saves the maximum possible amount of normal skin, and the particles are completely removed. Twenty patients have been treated with this technique and have obtained excellent results.

Accidents, Traffic↗