Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence

Abstract

Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injectionassociated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.

Basal cell carcinoma associated with non-neoplastic cutaneous conditions: a comprehensive review

“…A recent review summarized the features of 14 patients with tattooassociated BCC: eight men ranging from 35 to 76 years old (median, 49 years) and six women ranging Dermatology Online Journal || Review from 28 to 86 years old (median, 62 years). The tattoos were present from one to 57.5 years (median, 15 years) and were usually dark (11 of 12) and one color (nine of 12); the most common tattoo color was black (eight of 12), [54], Figure 3.…”

“…They ranged in size from 6×6 millimeters to 20×20 millimeters. Most (11 of 14) were asymptomatic; however, two were pruritic and one was initially painful [54].…”

“…Pathology subtypes were also variable: nodular, superficial, pagetoid, and mixed (nodular and sclerosing). All the tumors were treated with either a routine excision or Mohs micrographic surgery [54].…”

“…Some investigators propose that the tattoo influences the subsequent BCC development at that site secondary to a carcinogenic effect of the tattoo pigment and dyes in their native state or after alteration by ultraviolet radiation or the trauma associated with injection of the pigments and dyes, or both. Alternatively, other researchers attribute the observation of a BCC in a pre-existing tattoo to have occurred merely by chance alone [53,54].…”

“…H&E, A), 4×; B), 20×. The details of this patient have previously been reported; however, the figures included in this manuscript have not previously been published [54]. Dermatology Online Journal || Review during a 5-year period, the investigators were only able to collect 125 BCC occurring on the legs (2.3 percent).…”