Systemic contact dermatitis to a surgical implant presenting as red decorative tattoo reaction

Cobb, Hana Kathryn; Shinohara, Michi M.; Huss, Jason T.; Welch, Marshall P.; Gardner, Jennifer M.

doi:10.1016/j.jdcr.2017.05.003

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…With the evidence provided in this study arises the question of whether metallic wear from tattoo needles may indeed, just as Fe oxide pigments, play a role in allergic tattoo reactions. A connection between adverse tattoo effects, implant failure and also the use of TiO 2 in tattoo inks has already been reported [28, 29]. Sensitization is also promoted by co-stimulating factors like inflammation, which may develop directly after tattooing due to the skin injury caused by the tattooing procedure or if infections occur simultaneously [30].…”

Section: Discussionmentioning

confidence: 99%

Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions

et al. 2019

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Background Allergic reactions to tattoos are amongst the most common side effects occurring with this permanent deposition of pigments into the dermal skin layer. The characterization of such pigments and their distribution has been investigated in recent decades. The health impact of tattoo equipment on the extensive number of people with inked skin has been the focus of neither research nor medical diagnostics. Although tattoo needles contain high amounts of sensitizing elements like nickel (Ni) and chromium (Cr), their influence on metal deposition in skin has never been investigated. Results Here, we report the deposition of nano- and micrometer sized tattoo needle wear particles in human skin that translocate to lymph nodes. Usually tattoo needles contain nickel (6–8%) and chromium (15–20%) both of which prompt a high rate of sensitization in the general population. As verified in pig skin, wear significantly increased upon tattooing with the suspected abrasive titanium dioxide white when compared to carbon black pigment. Additionally, scanning electron microscopy of the tattoo needle revealed a high wear after tattooing with ink containing titanium dioxide. The investigation of a skin biopsy obtained from a nickel sensitized patient with type IV allergy toward a tattoo showed both wear particles and iron pigments contaminated with nickel. Conclusion Previously, the virtually inevitable nickel contamination of iron pigments was suspected to be responsible for nickel-driven tattoo allergies. The evidence from our study clearly points to an additional entry of nickel to both skin and lymph nodes originating from tattoo needle wear with an as yet to be assessed impact on tattoo allergy formation and systemic sensitization. Electronic supplementary material The online version of this article (10.1186/s12989-019-0317-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions

et al. 2019

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“…139 Systemic hypersensitivity to metallic implants was reported to facilitate tattoo hypersensitivity in two patients. 162,163 In two patients with complications in non-red tattoos, nickel (green) 168 and cobalt (blue) 137 were found to be PT positive. Blue or green tattoo inks were patch tested in three patients, respectively, 137,140,143,166,174 and in none of the cases, blue or green pigments were identified as culprits.…”

Section: Case Reports Of Patch Tested Tattoo Patientsmentioning

confidence: 97%

“…Patients with high levels of sensitizations to nickel may react to low concentrations, which are able to elicit reactions but not to induce sensitization 139 . Systemic hypersensitivity to metallic implants was reported to facilitate tattoo hypersensitivity in two patients 162,163 . In two patients with complications in non‐red tattoos, nickel (green) 168 and cobalt (blue) 137 were found to be PT positive.…”

Section: Patch Test Performance In Tattoo Patientsmentioning

confidence: 99%

Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997–2022

2023

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We outline constituents of tattoo and permanent make-up ink with regard to inflammatory tattoo reactions and population-based confounders. The comprehensive review of patch-tested tattoo patients between 1997 and 2022 shows that tattoo allergy cannot be reliably diagnosed via patch testing with today's knowledge. Weak penetration and slow haptenization of pigments, unavailability of pigments as test allergens and a lack of knowledge concerning relevant epitopes hamper the diagnosis of tattoo allergy. Patch testing p-phenylenediamine and disperse (textile) dyes is not able to close this gap. Sensitization to metals was associated with all types of tattoo complications, although often not clinically relevant for the tattoo reaction. Binders and industrial biocides are frequently missing on ink declarations and should be patch tested. The pigment carbon black (C.I. 77266) is no skin sensitizer. Patch tests with culprit inks were usually positive with cheap ink products for non-professional use or with professionally used inks in patients with eczematous reactions characterized by papules and infiltration. Tape stripping before patch testing and patch test readings on Day 8 or 10 may improve the diagnostic quality. The meaningfulness of the categorical EU-wide ban of Pigment Green 7 and Pigment Blue 15:3 is not substantiated by the presented data.

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“…In some rare cases, putative allergic reactions occurring in a tattoo may also be triggered by implant materials [69,70]. These reactions resolve with the removal of the implant.…”

Section: Type IV Hypersensitivity Reactionsmentioning

confidence: 99%

Tattoos – more than just colored skin? Searching for tattoo allergens

Weiß

Schreiver

Siewert

et al. 2021

J Deutsche Derma Gesell

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Summary During tattooing, a high amount of ink is injected into the skin. Tattoo inks contain numerous substances such as the coloring pigments, impurities, solvents, emulsifiers, and preservatives. Black amorphous carbon particles (carbon black), white titanium dioxide, azo or polycyclic pigments create all varieties of color shades in the visible spectrum. Some ingredients of tattoo inks might be hazardous and allergenic chemicals of unknown potential. In Germany, about 20 % of the general population is tattooed and related adverse reactions are increasingly reported. Since tattoo needles inevitably harm the skin, microorganisms can enter the wound and may cause infections. Non‐allergic inflammatory reactions (for example cutaneous granuloma and pseudolymphoma) as well as allergic reactions may emerge during or after wound healing. Especially with allergies occurring after weeks, months or years, it remains difficult to identify the specific ingredient(s) that trigger the reaction. This review summarizes possible adverse effects related to tattooing with a focus on the development of tattoo‐mediated allergies. To date, relevant allergens were only identified in rare cases. Here we present established methods and discuss current experimental approaches to identify culprit allergens in tattoo inks – via testing of the patient and in vitro approaches.

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Systemic contact dermatitis to a surgical implant presenting as red decorative tattoo reaction

Cited by 8 publications

References 10 publications

Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions

Distribution of nickel and chromium containing particles from tattoo needle wear in humans and its possible impact on allergic reactions

Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997–2022

Tattoos – more than just colored skin? Searching for tattoo allergens

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