BACKGROUND Awareness of accidental tattoos after iron injections with paravenous leakage is low. No larger patient cohorts have been analyzed. The lesions are a burden to the patients. The only known treatment is laser therapy. OBJECTIVE To characterize the clinical appearance and development of iron-induced tattoos and to demonstrate safe and efficient removal with quality-switched (QS) and picosecond lasers. MATERIALS AND METHODS The authors conducted a retrospective systematic analysis on patients who presented at the Dermatology Department of the University Hospital of Zurich between Year 2008 and 2017 with accidental hyperpigmentations after iron injections. From 29 collected patients, 13 received laser treatment and were analyzed with reference to the lasers used, including wavelength, fluence, spot size, intervals, number of sessions, and overall success. The authors defined the latter as a complete removal or as patients' satisfaction. RESULTS The authors treated 13 patients and completed the treatment in 8 patients, with an average of 5.6 sessions. No complications occurred. CONCLUSION Spontaneous regression of iron-induced tattoos is possible within 1 to 2 years, but not guaranteed. Removal with QS ruby, Nd:YAG, and picosecond lasers can be achieved within a mean number of 5.6 sessions. Assuring a valid indication before intravenous iron administration is important.

Background: Treatment with immune checkpoint and BRAF/MEK inhibitors has significantly improved the survival of patients with advanced cutaneous melanoma and other metastatic malignancies. Therapy-related uveitis is a rare ocular adverse event, which may potentially lead to legal blindness. The epidemiology of treatment-related uveitis is currently insufficiently known. Patients and methods: In this cohort study, we asked whether exposure to either immune checkpoint or BRAF/MEK inhibitors was associated with a higher risk of developing uveitis compared with the general population. Based on a Bayesian framework, we estimated the probability of developing uveitis with a right-censored, exponential survival model using data from the Zurich Melanoma Registry. The registry included all adult patients treated for advanced cutaneous melanoma between January 2008 and December 2018 at the University Hospital of Zurich, Switzerland. Results: In total, 304 patients (64%) were treated with immune checkpoint and 186 patients (38%) with BRAF/MEK inhibitors. Median follow-up time was 74 days (interquartile range: 57e233 days). Eleven patients developed uveitis and 30 patients died. We estimated the probability of developing uveitis per year in the general population as 0.05% (95% credibility interval [

Background: To date, information on laser treatment of accidental tattoos is limited. Objectives: This study analyzes the efficacy and safety of quality-switched ruby, quality-switched Nd:YAG and picosecond lasers in the treatment of accidental hyperpigmentation in a larger patient cohort. To date, there is limited information on laser therapy of accidental hyperpigmentation. Methods: We conducted a retrospective systematic single-center analysis on 70 patients, which presented with accidental hyperpigmentation at the Dermatology Department of the University Hospital of Zurich between 2008 and 2017. Patients with accidental tattoos due to road injuries, explosives or other traumas and iatrogenic measures were included. We analyzed the data including laser parameters such as wavelength, energy density, spot size and intervals between the sessions. Also, the number of sessions performed and the overall success were registered. Results: We treated 38 patients by quality-switched nano- and/or picosecond laser therapy and completed the treatment in 28 cases within a mean number of 3–5 laser sessions. No complications occurred. Conclusion: We demonstrate the validity and safety of quality-switched and picosecond lasers in the treatment of accidental hyperpigmentation. Using a combination of different wavelengths and pulse lengths on the same lesion and gradually increasing the fluence in the course of the laser treatment is recommendable to increase efficacy. We observed a tendency towards faster elimination of facial accidental tattoos and/or originating from road injuries compared to tattoos located on the extremities and those caused by explosions, piercings or iatrogenic measures or consisting of metal pigment particles.

Background and Aims: Acupuncture has become a substantial part of medical practice in Switzerland. So far, only few cases of accidental tattoo after acupuncture have been reported, which were all caused by acupuncture needles that had been left in the skin and led to local argyrosis. Case: We report the case of a 31-year-old female who developed gray-brown macules after acupuncture. Over 5 months, she had received acupuncture on the same spots one to two times per week and the macules had gradually become darker and had increased in size. The needles used were disposable, contained nickel and were not left in the skin for over 30 minutes. The patient was of Fitzpatrick skin phototype II and showed several grayish-brown macules with an average diameter of around 5mm in the region of glabella, nucha and dorsum pedis. We treated the lesions with a quality-switched ruby laser (694 nm) with a fluence between 3 and 5.5 J/cm 2 , a spot size of 4 or 6 mm and in intervals of 8 to 23 weeks up to a complete elimination of the hyperpigmentation within 11 laser sessions. Conclusion: In synopsis with the anamnesis, the clinical aspect and the therapeutic course, we interpreted the hyperpigmentary spots as a combination of iatrogenic tattooing with nickel and deposition of hemosiderin as well as melanin due to repeated mechanical manipulation and UV exposure of the skin. Furthermore, we hereby show the validity of the quality-switched ruby laser in the removal of accidental hyperpigmentation in skin phototype II.