“…It is the most common hypersensitivity tissue reaction that can occur in response to any ink color, but with a predilection for red ink due to the presence of components such as nickel, mercury, and cadmium, presenting even as verrucous lesions. 37 Lichenoid reactions can be caused by lichen planus or overlap with allergic reactions, and sometimes it is difficult to distinguish between these two etiologies, making clinical correlation crucial. Sometimes the lichenoid inflammatory pattern is associated with the Koebner isomorphic phenomenon in patients with undiagnosed lichen planus, so when it is found, other anatomical sites should be examined.…”