Diagnosis and Therapy of Tattoo Complications

With Atlas of Illustrative Cases

J. Serup, W. Bäumler, J., Serup, W., Bäumler, P. Itin, G. B. E. Jemec, P., Itin, G.B.E., Jemec

• Publisher: S. Karger
• Year: 2017
• Print ISBN: 9783318059779
• eBook ISBN: 9783318059786
• Topic: Medicine
• Subtopic: Immunology

Tattooing breaches the skin and can, therefore, cause a variety of complications. This book covers the full spectrum of issues clinical practitioners may encounter when treating affected patients. Introductory chapters include educational information on methods for tattooing, types of tattoos, tattoo inks, and tattoo ink toxicology. The focus is on the diagnosis and classification of tattoo complications. In this regard, a comprehensive atlas of acute and chronic complications serves as a valuable tool. Further chapters summarize available therapies, their rationale, and indication. This includes various medical and surgical treatments with a review of dermatome shaving. Lastly, tattoo removal by gold standard YAG lasers and the more recent pico-second lasers is discussed with the optimal therapeutic outcome in mind. Dermatologists, plastic surgeons, general practitioners, laser surgeons, and other specialists treating tattoo complications will find this book to be an indispensable resource. It also includes information relevant for a broad range of stakeholders in the tattoo business, including authorities and regulators.

Index of Cases

145	Bacterial Tattoo Infection with Staphylococci on the Patient’s Own Skin
146	Bacterial Tattoo Infection with Staphylococci from the Tattoo Ink Bottle
147	Bacterial Tattoo Infection with a Reused Tattoo Ink Bottle as the Suggested Source of Infection
148	Bacterial Tattoo Infection in a Patient with Type 1 Diabetes
149	Allergic Reaction in a Red Tattoo: Type Plaque Elevation
155	Allergic Reaction in the Red Part of a Multicolored Tattoo: Type Plaque Elevation
156	Allergic Reaction in the Bordeaux Part of a Multicolored Amateur Tattoo with Atypical Nodular Appearance
157	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis
161	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis in a Case Predisposed to Hyperkeratotic Response to Physical Stimuli
162	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis, Acneiform Variant with Epidermoid Cysts
163	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis, Acneiform Variant with Epidermoid Inclusions
164	Allergic Reaction Provoked by Sun in Two Red Tattoos Made with Different Red Inks
165	Allergic Reaction in a Red Tattoo: Type Plaque Elevation with Cross-Sensitivity Reactions in Other Red Tattoos Hitherto Tolerated
166	Allergic Reaction in a Red Tattoo Triggering a Cross-Sensitivity Reaction in a Number of Red Tattoos Acquired in the Past
167	Allergic Reaction in a Red Tattoo Triggering an Allergic Cross-Reaction in Other Red Tattoos as well as in a Green Tattoo
168	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis-Uncomplicated Dermatome Shaving
169	Allergic Reaction in a Red Tattoo: Type Excessive Hyperkeratosis, Acneiform Variant - Dermatome Shaving Followed by Epidermoid Growth and Prolonged Healing
170	Aggressive Necrosis in a Multicolored Tattoo with Successive Amputations of the Leg, Chronically Impaired Wound Healing, and Generalized Dermopathy
172	Allergic Reaction in a Red Tattoo: Type Ulceronecrotic Reaction, Severe
173	Allergic Reaction in a Blue Tattoo Parallel to Spontaneous Color Shift in the Direction of Green
174	Allergic Reaction in a Blue Tattoo with Pigment Blowout
175	Allergic Reaction in the Lilac Part of a Multicolored Tattoo: Type Plaque Elevation
176	Allergic Reaction in a Lilac Tattoo: Type Excessive Hyperkeratosis with Parallel Reaction in Lymph Nodes
177	Allergic Eczema in a Cover-Up Tattoo with Progression into the Surrounding Skin
178	Generalized Allergic Eczema after a New Tattoo Caused by Primary Sensitization to Nickel
179	Generalized Allergic Eczema due to Primary Sensitization by Tattooing: Allergen Not Identified
180	Generalized Allergic Eczema the Day after Tattooing due to Preexisting Strong Allergy to Nickel
181	Generalized Dermatitis after Sensitization to Parabens from the Tattoo Ink
182	Allergic Eczema in a Patient with a Tattoo Reaction and Known Hair Dye Allergy with the Rash Possibly Elicited by a PPD Analogue
183	Henna Tattoo Reaction with Generalized Dermatitis: Is PPD Allergy Also a Potential Risk with Permanent Tattooing?
184	Reaction in a Black Tattoo:Type Papulonodular Reaction
185	Pigment Overload Reaction in a Black Tattoo: Type Papulonodular Reaction Treated with Surgical Excision
186	Pigment Overload with Mild Papulonodular Reaction and Sensitivity to Sun
187	Pimples after Tattooing with Black Ink
188	Black Tattoo with Pigment Blowout
189	Black Tattoo with Pigment Blowout to the Surrounding Skin with a Halo Nearby the Tattoo
190	Black Tattoo with Pigment Blowout to Underlying Structures, Subcutaneous Inflammation, and Painful Shoulder
191	Sarcoidosis Locally in a Black Tattoo with a Papulonodular Reaction
192	Sarcoidosis in Black and Brown Tattoos with Erythema Nodosum
193	Sarcoidosis in a Black Tattoo Associated with Scar Sarcoidosis and Erythema Nodosum
194	Sarcoidosis in Black Tattoos with Enlarged Regional Lymph Nodes and Associated Iridocyclitis
196	Sarcoidosis in Black Tattoos Accompanied by Erythema Nodosum, Joint Affection, and Involvement of the Lungs with the Tattoo Reaction as the Clue to Diagnosis
197	Sarcoidosis in Black Tattoos Manifested as a Rush Phenomenon
198	Sarcoidosis in Black Tattoos Starting Abruptly as a Rush Phenomenon in Every Black Tattoo
200	Sarcoidosis in Black Tattoos with Associated Rush Phenomenon in Other Black Tattoos and Affection of the Ankle Joints
202	Sarcoidosis in Black Tattoos with Rush Phenomenon and Pulmonary Affection
204	Neurosensitive Tattoo Reaction in a Red Tattoo with Constant Itch and Pain
205	Neurosensitive Tattoo Reaction Associated with Exercise Addiction Threatening the General Health
206	Neurosensory Complaints and Color Change after Bacterial Tattoo Infection
207	Neurosensitive Reaction in a Blue Tattoo in a Case with Known Urticaria
208	Disturbed Sensitivity and Urticarial Reaction in a Red Tattoo
209	Basal Cell Carcinoma in a Tattoo by Coincidence
210	Keratoacanthoma(s) in a Tattoo with Spontaneous Recovery
212	Paraneoplastic Reaction in a Multicolored Tattoo Provoked by Malignant Lymphoma
213	Köbner Provocation of Psoriasis in a Recent Tattoo
214	Köbner Provocation of Psoriasis in a Tattoo with a Papulonodular Reaction in Black Pigment Maintaining Local Psoriatic Activity around the Tattoo
215	Tattoo Needle Trauma of the Skin Followed by Abnormal Healing of the Tattoo
216	Traumatic Tattooing with Severe Local Damage and Chronic Sequels
218	Tattoo Inflammation of a Newly Acquired Tattoo from Physicochemical Insult
219	Amateur Tattoo of the Oral Mucosa with Unintended Tattooing of the Lip
220	Tattoo and Risk of Keloid
221	Keloid following Dermatome Shaving on the Chest, a Region Predisposed to Abnormal Scarring
222	Laser Removal of a Tattoo Followed by Scarring and Chronic Itch and Pain
223	Laser Removal of a Tattoo in an Amateur Setting Causing Laser Burn and a Chronic Papulonodular Reaction
224	Laser Removal of a Tattoo with Poor Outcome and Followed by Scarring and Urticaria Factitia in the Treated Field
225	Tattoo Removal by Laser with Yellow, Green, and Blue Pigment Resistance to Treatment
226	Tattoo Removal by a Caustic Product Causing a Scar
227	Caustic Tattoo Removal with Lactic Acid Causing a Scar and Psychological Complications
228	Caustic Tattoo Removal with Lactic Acid Followed by a Disfiguring Scar
229	Caustic Tattoo Removal with Lactic Acid in a Person Predisposed to Abnormal Scarring

Bacterial Tattoo Infection with Staphylococci on the Patient’s Own Skin

History

After 1 day, a new tattoo on the arm started to develop painful swelling and oozing involving most of the tattoo. The tattoo parlor was professional and gloves as well as single-use needles were used; the disinfection routine was unknown. The general practitioner started treatment with penicillin and fusidic acid cream. The patient had a history of abscess, paronychia, and other cutaneous infections on 3 occasions with documented staphylococci as the causative microorganism. His history also included a previous tattoo with bacterial infection of the surrounding skin.

Comment

The photo shows the tattoo infection in the state of healing, with crusts and oozing in the sites of the tattoo where the infection was severe. The sites of the tattoo that already healed, i.e. lilac parts, show pigment loss, which will also happen in additional sites presently covered with crusts. It is common that pyogenic infections destroy the color of tattoos, with massive pigment escape to the surface during infection while the skin barrier is temporarily open. Infection may also induce color change, for example from blue to greenish.

Treatment

Treatment was oral antibiotics with a combination including penicillinase-resistant penicillin. The patient was screened for staphylococci including MRSA in sites of predilection.

Bacterial Tattoo Infection with Staphylococci from the Tattoo I...

Table of contents

• Cover Page
• Front Matter
• From Technique of Tattooing to Biokinetics and Toxicology of Injected Tattoo Ink Particles and Chemicals
• Individual Risk and Prevention of Complications: Doctors’ Advice to Persons Wishing a New Tattoo
• Tattoo Infections, Personal Resistance, and Contagious Exposure through Tattooing
• Diagnostic Tools for Doctors’ Evaluation of Tattoo Complications
• How to Diagnose and Classify Tattoo Complications in the Clinic: A System of Distinctive Patterns
• Medical Treatment of Tattoo Complications
• Surgical Treatment of Tattoo Complications
• Laser Treatment of Tattoos: Basic Principles
• Removal of Tattoos by Q-Switched Nanosecond Lasers
• New and Advanced Picosecond Lasers for Tattoo Removal
• Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal
• Guide to Treatment of Tattoo Complications and Tattoo Removal
• Atlas of Illustrative Cases of Tattoo Complications
• Index of Cases
• Author Index
• Subject Index
• Back Cover Page