Molluscum Contagiosum Over Tattooed Skin

Abstract

A 33-year-old Spanish male presented to the Department of Dermatology & Venereology at the Virgen de las Nieves Hospital, Granada, Spain, in February 2015 with pruritic skin lesions located over a tattoo on his right arm. The tattoo had been completed three months earlier without protective measures by the patient's friend at his home. At presentation, the patient was not suffering from any known illnesses. A physical examination showed several pearled papules of 0.3-0.5 cm located over the tattoo [ Figure 1A]. The papules were umbilicated and occurred over the lines of the tattoo [ Figure 1B]. Biochemical tests and a haemogram were normal. Serology for hepatitis B and C, human immunodeficiency virus (HIV) and syphilis was negative. The patient was diagnosed with molluscum contagiosum (MC) and treated with curettage, with a subsequent healing time of three weeks.

Tattoo-Associated Viral Infections: A Review

“…Hepatitis B virus [4][5][6] Hepatitis C virus [4,[6][7][8] Herpes simplex virus [9][10][11] Human immunodeficiency virus [4,12,13] Human papillomavirus [3,14,15,[33][34][35] Molluscum contagiosum virus [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Rubella (German measles) virus [30] Vaccinia (smallpox) virus [31,32] However, hepatitis C transmission from tattoos is prevalent in persons who use intravenous drugs, prisoners, and veterans. Indeed, there is also an increased risk of hepatitis C virus transmission if a tattoo is applied by friends, acquired in prison using non-sterile equipment, or if the recipient belongs to a high-risk group.…”

“…19,23 Tattoo-related molluscum contagiosum has been observed (Table 5). [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Characteristics of these individuals have been provided for 11 of the patients: one woman and 10 men. The individuals were most frequently from Spain (five patients) and Italy (three patients); one patient was from either Brazil, England, or France.…”

“…Subsequently, 3 months later, the 33-year-old Spanish man presented with several pruritic molluscum contagiosum located on the inked lines of the tattoo on his right arm. 24 The molluscum contagiosum appeared two to 24 weeks (median, 12 weeks) after the tattoo was performed. When specified, the number of lesions ranged from 10 to 50 lesions (median, 20 lesions).…”

Tinea confined to tattoo sites - An example of Ruocco's immunocompromised district

“…They also cite some interesting articles that observed molluscum contagiosum and verrucae preferentially appearing in black tattoos and allude to the possibility of black tattoo ink diminishing cellular as well as humoral immunity. [234] They have substantiated the hypothesis of the immunosuppressive effect of the black ink having a putative role in their cases of tinea at the tattoo sites, although without an explanation which would have indeed been useful at this juncture. Black ink is composed primarily of nanoparticles and contains polycyclic aromatic hydrocarbons (PAH) that are well established environmental pollutants.…”

Tinea lesions confined to tattoo site

“…Direct cutaneous inoculation can occur at the tattoo site through contaminated instruments or due to reduced local, humoral, and cellular immunity due to black pigment in the tattoo ink. [12]…”