Delayed onset of warts over tattoo mark provoked by sunburn

Abstract

Multiple warts in a 32-year-old-man are reported that developed after tattooing and remaining exclusively confined to that area. The tattooing was done 2.5 years earlier by a professional tattoo artist. It was previously a lesion-free tattoo, but when damaged by sunburn developed multiple skin warts. The ability of a latent virus to induce warts after cutaneous ultraviolet exposure was discussed.

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

“…In one case, a 32-year-old man experienced development of multiple warts restricted to the tattooed area after sunburn damage. The tattoo had been performed 2.5 years previously, so in this case, HPV persisted asymptomatically for a long period before activation by local UV-induced immunosuppression resulting in multiple warts [43]. There are also reports on the appearance of Molluscum contagiosum caused by Poxviridae and of Herpes simplex virus (HSV) infection in tattooed areas, also via transmission during the tattooing process (see category 2, table 2).…”

The histopathologic spectrum of decorative tattoo complications

“…In one case multiple verrucae limited to one color of a tattoo developed, implicating HPV innoculation via the tattoo ink . Sunburn on an established tattoo was an additional inciting factor in one case . Whether some verrucous lesions represent true HPV infection or verrucous inflammatory reactions is not clear, as the presence of HPV virus cannot always be showed …”

Human papillomavirus type 27 associated with multiple verruca within a tattoo: report of a case and review of the literature

“…More recently, facial verruca plana was reported to develop one year after semipermanent tattooing 9 . The latency period, or time to onset of new warts, ranged from two months to 10 years after tattooing 5–12 . Modes of inoculation are thought to be due to contamination of the tattoo instrument, contamination of the individual colors, koebnerization of previously unnoticed verruca in the area of the tattoo, or contamination from the artist's saliva 7 .…”

“…Modes of inoculation are thought to be due to contamination of the tattoo instrument, contamination of the individual colors, koebnerization of previously unnoticed verruca in the area of the tattoo, or contamination from the artist's saliva 7 . In addition, delayed activation of HPV and induction of warts in a tattoo has also been described after ultraviolet exposure with onset 2.5 years after skin tattooing, implying that HPV may have a long latency period and can be triggered by environmental stressors 11 . The case presented herein also describes a longer latency period before appearance of verruca, supporting previous reports.…”