Azo Pigments and a Basal Cell Carcinoma at the Thumb

Abstract

Basal cell carcinoma is the most common malignant neoplasm of the skin, whereas the localization at the nail unit is very rare. We report the case of a 58-year-old patient with a periungual basal cell carcinoma at the thumb. The specific feature of the reported case is the frequent exposure to fishing baits that the patient had stained with an unknown colorant. The use of chromatography, mass spectrometry and infrared spectroscopy revealed the colorant as the azo pigment Solvent Red 8. Solvent Red 8 is a widespread synthetic azo pigment that is applied to stain consumer products. Compounds such as Solvent Red 8 can be cleaved to carcinogenic amines under, for example, light exposure, in particular after incorporation into the human body. As a result of the frequent skin contact to this azo pigment, this hazard compound might have induced the basal cell carcinoma in our patient.

Adverse Reactions after Tattooing: Review of the Literature and Comparison to Results of a Survey

“…This is also the case with KA. Engel et al [54 ]made quite an interesting observation. They reported an uncommon case of BCC of the thumb of a 58-year-old man due to an azo-pigment-containing colorant repeatedly used as a marker of fishing bait.…”

Periungual basal cell carcinoma: A case report with review of literature

“…Trauma could have been an inciting factor in our case, while others[28] reported a case of BCC of the nail unit in an angler who had the habit of coloring his baits with an azo dye to attract the fishes. The dye was incriminated in the causation of the carcinoma.…”

“…Male: female ratio was 1.8:1. The thumb was the most frequently affected site[568912131519242628] and the hallux was reported in five cases. [1118212227] The right middle finger was involved in three cases[41620] and both hands were affected with almost similar frequency.…”

“…This drug is an imidazoquinolone amine and is known to promote cytokine-mediated cellular immune response. [3] Information about such type of malignancy in this region is rare and extensive search of the English literature revealed 25[4–28] similar cases.…”

Skin Cancers Arising in Tattoos: Coincidental or Not?

“…Unfortunately, only in vitro data are available to date: they show that some azo dyes, under certain circumstances (laser therapy, UV exposure), may lead to the increase of some carcinogenic substances such as 3-3′ dichlorobenzidine [22, 23]. Recently, Engel et al[ 24] showed the role of an azo dye in the development of a BCC of the thumb. However, the relevance of such data in the specific case of tattoos is not clear as we lack in vivo data [25].…”