Here is a 2017 Summary of Published Medical Journal Articles Involving Body Piercing, Modifications, & Tattooing
Submitted to the APP et al on 8/28/17
All articles and abstracts summary was performed by Scott L. DeBoer RN,MSN,EMT-P
Founder: Pedi-Ed-Trics Emergency Medical Solutions
Transport Nurse: MedEx Chicago
List & Summaries of 1/1/17-8/25/17 Published Medical Articles on Body Art
This list is reproduced with the explicit authorization of Scott DeBoer. All credits for this work goes to him.
The articles are classified by the family name of the first author from A to Z
Adatto, M., et al. (2017). New and Advanced Picosecond Lasers for Tattoo Removal. Curr Probl Dermatol. 52. 113-123.
– Early methods of tattoo removal ultimately resulted in unacceptable cosmetic outcomes. While the introduction of laser technology was an improvement over the existing chemical, mechanical, and surgical procedures, the use of nonselective tattoo removal with carbon dioxide and argon lasers led to scarring. Q-switched lasers with nanosecond (10-9) pulse domains were considered to have revolutionized tattoo treatment, by selectively heating the tattoo particles, while reducing the adverse sequelae to adjacent normal skin. Theoretical considerations of restricting pulse duration, to heat tattoo particles to higher temperatures, proposed the use of sub-nanosecond pulses to target particles with thermal relaxation times lower than the nanosecond pulses in Q-switched lasers. Initial studies demonstrated that picosecond (10-12) pulses were more effective than nanosecond pulses in clearing black tattoos. Advances in picosecond technology led to the development of commercially available lasers, incorporating several different wavelengths, to further refine pigment targeting.
Ahn, K., et al. (2017). Simulation of laser-tattoo pigment interaction in a tissue-mimicking phantom using Q-switched and long-pulsed lasers. Skin Res Technol. 23(3). 376-383.
– A Q-switched (QS) neodymium-doped yttrium aluminum garnet laser was used at settings of 532-, 660-, and 1064-nm wavelengths, single-pulse and quick pulse-to-pulse treatment modes, and spot sizes of 4 and 7 mm. Most of the laser-tattoo interactions in the experimental conditions formed cocoon-shaped or oval photothermal and photoacoustic injury zones, which contained fragmented tattoo particles in various sizes depending on the conditions. In addition, a long-pulsed 755-nm alexandrite laser was used at a spot size of 6 mm and pulse widths of 3, 5, and 10 ms. The finer granular pattern of tattoo destruction was observed in TM phantoms treated with 3- and 5-ms pulse durations compared to those treated with a 10-ms pulse.
– We outlined various patterns of laser-tattoo pigment interactions in a tattoo-embedded TM phantom to predict macroscopic tattoo and surrounding tissue reactions after laser treatment for tattoo removal.
Ahn, K., et al. (2017). Pattern analysis of laser-tattoo interactions for picosecond- and nanosecond-domain 1,064-nm neodymium-doped yttrium-aluminum-garnet lasers in tissue-mimicking phantom. Sci Rep. 7(1). 1533.
– During laser treatment for tattoo removal, pigment chromophores absorb laser energy, resulting in fragmentation of the ink particles via selective photothermolysis. The present study aimed to outline macroscopic laser-tattoo interactions in tissue-mimicking (TM) phantoms treated with picosecond- and nanosecond-domain lasers. Additionally, high-speed cinematographs were captured to visualize time-dependent tattoo-tissue interactions, from laser irradiation to the formation of photothermal and photoacoustic injury zones (PIZs). In all experimental settings using the nanosecond or picosecond laser, tattoo pigments fragmented into coarse particles after a single laser pulse, and further disintegrated into smaller particles that dispersed toward the boundaries of PIZs after repetitive delivery of laser energy. Particles fractured by picosecond treatment were more evenly dispersed throughout PIZs than those fractured by nanosecond treatment. Additionally, picosecond-then-picosecond laser treatment (5-pass-picosecond treatment + 5-pass-picosecond treatment) induced greater disintegration of tattoo particles within PIZs than picosecond-then-nanosecond laser treatment (5-pass-picosecond treatment + 5-pass-nanosecond treatment).
Aktas, A., et al. (2017). Monitoring of Lawsone, p-phenylenediamine and heavy metals in commercial temporary black henna tattoos sold in Turkey. Contact Dermatitis. 76(2). 89-95.
– To determine the presence of, and quantify, Lawsone, PPD and heavy metal contaminants (cobalt, nickel, lead, and chromium) in commercial temporary black henna tattoo mixtures (n = 25) sold in Turkey.
– Our results suggest that commercial temporary black henna mixtures containing PPD levels up to 51.6% pose a risk of contact sensitization and severe allergic contact dermatitis among users. It is important to identify both the additives and metallic contaminants of black henna tattoo products; the significance of metal contaminants has still to be assessed.
Allen, D. (2017). Moving the Needle on Recovery From Breast Cancer: The Healing Role of Postmastectomy Tattoos. JAMA. 317(7). 672-674.
Amadori, F., et al. (2017). Oral mucosal lesions in teenagers: a cross-sectional study. Ital J Pediatr. 43(1). 50.
– Adolescence is a period of transition to adulthood. Little is known about oral mucosal lesions (OMLs) in teenagers, in which the emergence of new habits, unfamiliar to children, could affect the type of lesions. The aim of this study was to evaluate the distribution of oral mucosal lesions (OMLs) in a wide sample of adolescents.
– A retrospective cross-sectional study was carried out examining all medical records of adolescents (aged 13-18 years) treated at the Dental Clinic of the University of Brescia (Italy) in the period from 2008 to 2014.
– … piercing-related lesions (4%)…
– The prevalence of OMLs in adolescents are different from those in children and, in some conditions, it could increase with age.
Ayanlowo, O., et al. (2017). Growing trend of tattooing and its complications in Nigeria. Int J Dermatol. 56(7). 709-714.
– However, since the late 20th century, tattooing has undergone a redefinition and shifted to an acceptable form of expression all over the world, including Nigeria, cutting across almost all age groups and socioeconomic class. This review is aimed at highlighting the indication, complications arising from the procedure as well as removal, and how to manage them. The dermatological complications associated with tattoos can occur either during inking or attempts at removal. Most times, tattoos are obtained through unsafe means by unauthorized personnel, and this is associated with numerous health risks.
– In conclusion, the trend of tattooing has become a widely accepted form of social expression all over the world and is gradually gaining ground in Nigeria. Patients frequently present to the dermatologists and physicians for solutions to the complications. It is important to proffer solutions and educate patients on the various health risks associated with tattooing.
Bareket, L., et al. (2017). Corrigendum: Temporary-tattoo for long-term high fidelity biopotential recordings. Sci Rep. (7).
Baumler, W. (2017). Laser Treatment of Tattoos: Basic Principles. Curr Probl Dermatol. 52. 94-104.
– Tattooing has become very popular worldwide during the past decades, and millions of people have one or many tattoos at different anatomical sites. The color of tattoos is mainly black, followed by red, green, blue, and other colors. A part of the tattooed people regret tattooing or have permanent problems with tattoos and therefore seek for tattoo removal.
– Laser therapy is most effective in black tattoos and less effective for colored tattoos. The rate of side effects is low due to the selectivity of the treatment. Laser light may change the chemistry of the tattoo pigments and hence provoke toxic decomposition products.
Bellaud, G., et al. (2017). Bacterial chondritis complications following ear piercing. Med Mal Infect. 47(1). 26-31.
– We conducted a retrospective study of patients presenting with post-piercing chondritis in the infectious disease department of Tenon Hospital, Paris, France.
– We included 21 patients. Fifteen bacteriological cultures were positive (7 Pseudomonas aeruginosa, 5 Staphylococcus aureus, and three other).
– Transcartilaginous ear piercing may lead to infectious complications or deformity. In case of chondritis, early administration of an antibiotic therapy active against P. aeruginosa and S. aureus is recommended.
Biesman, B. & Costner, C. (2017). Evaluation of a transparent perfluorodecalin-infused patch as an adjunct to laser-assisted tattoo removal: A pivotal trial. Lasers Surg Med. 49(4). 335-340.
– Laser-assisted treatment of tattoos is well recognized to produce opaque epidermal whitening that prevents multiple sequential passes during a single treatment session. The amount of epidermal whitening produced in association with the procedure can be minimized by topical application of perfluorodecalin (PFD), which is an optical clearing agent. This pivotal trial assessed the ability of a transparent PFD-infused patch used in conjunction with a Q-switched nanosecond laser in the treatment of tattoos to permit multiple laser passes during a single 5 minute treatment session in comparison to the number of passes that could be completed using conventional treatment of the tattoo with the laser alone.
– Significantly more laser passes could be made on average using the PFD patch compared with treatment using the laser alone (3.7 passes vs. 1.4 passes; P < 0.001). AEs were limited to those expected during laser removal of tattoos. The proportions of subjects with transient edema and erythema were lower in the PFD patch treatment group (36.7% vs. 63.3% and 33.3% vs. 70.0%, respectively); all AEs were transient and resolved quickly. No patient in either group exhibited dyschromia (hypo- or hyperpigmentation) in the treatment area at the 1-month post treatment visit. Additionally, when surveyed at the 1-month follow-up visit, all subjects (30/30) preferred to continue laser-assisted tattoo removal with the PFD patch.
– An average of 3.7 laser passes were made in a defined 5-minute treatment session when using the transparent PFD-infused patch, which is significantly more than was possible with the laser alone (average of 1.4 passes). Use of the PFD patch was associated with improved tolerability compared with conventional treatment, with subjects experiencing fewer and less severe AEs related to epidermal injury.
Bircher, A., et al. (2017, July 4). Allergic contact dermatitis caused by a new temporary blue-black tattoo dye – sensitization to genipin from jagua (Genipa americana L.) fruit extract. Contact Dermatitis.
– Temporary tattoos made with an extract of the jagua fruit (Genipa americana L.) are becoming increasingly popular. It is claimed that it is ‘dermatologically tested’ and does not contain p-phenylenediamine.
– A 39-year-old female who repeatedly applied ‘completely natural and 100% safe’ Earth Jagua® tattoo, obtained via the internet, to her left hand developed allergic contact dermatitis within 6 weeks. Analysis of the dye showed the presence of geniposide and genipin.
– We report an extensively evaluated case of allergic contact dermatitis caused by a temporary Earth Jagua® tattoo. The allergen identified is genipin, a substance that is increasingly used for tattoos and as a therapeutic agent in medicine. This could result in an increase in the number of allergic reactions in the future.
Boulart, L., et al. (2017). Dealing with tattoos in plastic surgery. Complications and medical use. Ann Chir Plast Esthet. 62(2). e23-329.
– Not only has tattooing been socially performed for thousands of years, but it has also been part and parcel of medical practice since antiquity. In our day and age, plastic surgeons are ever more frequently compelled to deal with tattooing, whether in terms of its medical application or its complications. While the process itself may appear harmless, it is not without risk and necessitates use of suitable tools and management by expert hands.
Burlingame, B. (2017). Clinical Issues-January 2017. AORN J. 105(1). 110-116.
Caccavale, S., et al. (2017). Herpes compuctorum: a cutaneous infection related to permanent tattoo. Int J Dermatol. 56(7). e148-e149.
Calderia, S., et al. (2017). Tattoo or no tattoo? A contemporary ethical issue in nursing education. Nurs Ethics. 24(5). 626-628.
Calogiuri, G., et al. (2017). Hypersensitivity reactions due to black henna tattoos and their components: are the clinical pictures related to the immune pathomechanism? Clin Mol Allergy. 15(8).
– Here we review the various clinical patterns related to PPD and henna tattoo, to investigate the possible link between clinic-morphological pictures and the immunological response to PPD and henna. The literature underlines that different clinical manifestations are related to black henna containing PPD, and its derivative products may cause delayed-type as well as immediate-type reactions.
Chheda, K., et al. (2017). The tattoo removal ethical conundrum: Should a physician be part of a minor patient’s punishment? J Am Acad Dermatol. 77(2). 385-387.
Cobb, H., et al. (2017). Systemic contact dermatitis to a surgical implant presenting as red decorative tattoo reaction. JAAD Case Rep. 3(4). 348-350.
– Up to 5% of orthopedic implant patients suffer metal-related cutaneous complications caused by delayed-type hypersensitivity reactions, most commonly to nickel, cobalt, and chromium. Both generalized and remote site dermatitis to orthopedic implants are uncommon.
– Traditional and decorative tattoos have been given for thousands of years around the world and remain a popular practice in modern times, with as many as 3 in 10 adults reporting having 1 or more tattoos. As more people get tattoos, the rate of complications, which may be as high as 2%, is likely to increase. Adverse tattoo reactions are common and predominantly affect red pigmented areas. Although reactions were often caused by an allergy to particular metals within pigments in the past, with the shift toward the use of azo dyes, the mechanism is unclear.
– A 57-year-old woman with diabetes mellitus and an unremarkable dermatologic history underwent placement of a first metatarsophalangeal joint hemi implant with cobalt chromium hardware coated with titanium plasma and hydroxyapatite. The patient reported that within 2 weeks of surgery, the red-containing areas of her tattoos, which were previously flat and uninflamed, became raised and pruritic. Oral antihistamines and emollients resulted in only partial symptom relief. Her symptoms temporarily resolved after a combination of intralesional injections with triamcinolone suspension (10 to 40 mg/mL) at intervals of every 1 to 2 months and triamcinolone 0.1% cream only to recur several weeks after each injection.
– With the frequency of tattooing and surgery involving metallic implants both increasing, it seems inevitable that adverse tattoo reactions possibly related to metallic implants will also increase. This case exemplifies the need for clinicians to be able to recognize and diagnose these cutaneous complications and be aware of treatment options available.
Colbert, S. & Brennan, P. (2017). Tattoos: could they be used to advantage as a medical alert in oral and maxillofacial surgery? Br J Oral Maxillofac Surg. 55(3). 300-301.
– Many publications have addressed the medical complications of tattoos, but to our knowledge there are no reports of their use to alert people in our field of potentially dangerous conditions. We present a new way to inform oral and maxillofacial colleagues about patients with a history of malignant hyperthermia (or any other life-threatening medical problem) and discuss the potential advantages and disadvantages of medical alert tattoos.
Conti, R., et al. (2017). Pseudoepitheliomatous hyperplasia in a tattoo. G Ital Dermatol Venereol. 152(1). 71-72.
Coppola, N., et al. (2017). Hepatitis B virus infection in undocumented immigrants and refugees in Southern Italy: demographic, virological, and clinical features. Infect Dis Poverty. 6(1). 33.
– The data on hepatitis b virus (HBV) infection in immigrants population are scanty. The purpose of this study was to define the demographic, virological, and clinical characteristics of subjects infected with HBV chronic infection in a cohort of immigrants living in Naples, Italy.
– Of the 1,212 immigrants screened, 116 (9.6%) were HBsAg positive, 490 (40.4%) were HBsAg negative/anti-HBc positive, and 606 (50%) were seronegative for both. Moreover, 21 (1.7%) were anti-human immunodeficiency virus positive and 45 (3.7%) were anti-hepatitis C virus positive. The logistic regression analysis showed that male sex, Sub-Saharan African origin, low level of schooling, and minor parenteral risks for acquiring HBV infection (acupuncture, tattoo, piercing, or tribal practices, were independently associated with ongoing or past HBV infection.
Cornelissen, A., et al. (2017). Breast Implant Infection After Nipple Piercing. Aesthet Surg J. 37(1). NP3-NP4.
Corso, G., et al. (2017, July 15). Axillary blue sentinel lymph node: an unusual tattoo? Eur J Nucl Med Mol Imaging.
Cozzi, S., et al. (2017). Tattoo removal with ingenol mebutate. Clin Cosmet Investig Dermatol. 10. 205-210.
– An increasing number of people are getting tattoos; however, many regret the decision and seek their removal. Lasers are currently the most commonly used method for tattoo removal; however, treatment can be lengthy, costly, and sometimes ineffective, especially for certain colors. Ingenol mebutate is a licensed topical treatment for actinic keratoses. Here, we demonstrate that two applications of 0.1% ingenol mebutate can efficiently and consistently remove 2-week-old tattoos from SKH/hr hairless mice.
Crowther, A., et al. (2017). Exploring the motivations for body piercing: A pilot study. Issues Ment Health Nurs. 38(8). 682-683.
Cunningham, R., et al. (2017). Another Tattoo Reaction Pitfall: A Pink Lamb in Wolf’s Clothing. JAMA Dermatol. 153(5). 463-464.
de Cuyper, C., et al. (2017, August 9). Are metals involved in tattoo-related hypersensitivity reactions? A case report. Contact Dermatitis.
– Allergic reactions to tattoos are not uncommon. However, identification of the culprit allergen(s) remains challenging.
– We present a patient with papulo-nodular infiltration of 20-year-old tattoos associated with systemic symptoms that disappeared within a week after surgical removal of metal osteosynthesis implants from his spine. We aimed to explore the causal relationship between the metal implants and the patient’s clinical presentation.
– Nickel (Ni) and chromium (Cr) as well as high levels of titanium (Ti) and aluminium were detected in both the skin biopsy and the implants. XRF analyses identified Cr(III), with Cr(VI) being absent. Patch testing gave negative results for Ni and Cr. However, patch tests with an extract of the implants and metallic Ti on the tattooed skin evoked flare-up of the symptoms.
– The patient’s hypersensitivity reaction and its spontaneous remission after removal of the implants indicate that Ti, possibly along with some of the other metals detected, could have played a major role in this particular case of tattoo-related allergy.
Escudero-Gongora, M., et al. (2017). Reactive perforating collagenosis on a tattoo. J Eur Acad Dermatol Venereol. 31(2). e87-e89.
Fania, L., et al. (2017). Tattoo and warts: efficacy of topical immunotherapy. Eur J Dermatol. 27(3). 322-323.
Flynn, A., et al. (2017). Image Gallery: Systemic sarcoidosis presenting within the black pigment of a cosmetic tattoo. Br J Dermatol. 176(1). e2.
Friedmann, D., et al. (2017). Localized Cutaneous Argyria From a Nasal Piercing Successfully Treated With a Picosecond 755-nm Q-Switched Alexandrite Laser. Dermatol Surg. 43(8). 1094-1095.
Friedmann, D., et al. (2017). Keloidal Scarring From the At-Home Use of Intense Pulsed Light for Tattoo Removal. Dermatol Surg. 43(8). 1112-1114.
Garve, R., et al. (2017). Labrets in Africa and Amazonia: medical implications and cultural determinants.Trop Med Int Health. 22(2). 232-240.
– The custom of wearing labrets has a long tradition. Labrets appeared independently several thousand years ago in various culture groups in Asia, Europe, Africa and the Americas. Today, apart from diverse body modifications as increasingly practiced in western civilisations, lip plates and plugs are found among a small number of tribal groups only in Africa and Amazonia. We summarise the history of labrets in different societies, describe medical consequences of wearing lip plates and plugs for jaws and teeth and address relevant cultural issues.
Grannan, S. (2017). Understanding patient perceptions and risk for hepatitis C screening. J Viral Hepat. 24(8). 631-635.
– The specific aims were to identify specific themes and barriers to viral hepatitis C (HCV) testing and to determine if testing rates increased when patients self-identify their risk factors and were offered testing.
– The typical participant (N=111) was female (74%), Baby Boomer (1945-1965) generation (45%), white (86%), and uninsured (54%). Top 6 self-identified risks were tattoo and/or body piercings (47.7%), Baby Boomer (36%), multiple sex partners (18%), work-related exposure (8.1%), non-injection drug use (8.1%), and injection drug use (7.2%). Only 78% of Baby Boomers identified being a Baby Boomer as a risk. Eighty-one percent of participants did not want to test.
– Main reasons not to test were « I do not have any risk factors » (30.2%), concerned with cost (15.1%), tested in the past (15.1%), other reasons (9.3%), not feeling well (5.8%)
Greveling, K., et al. (2017). Non-invasive anaesthetic methods for dermatological laser procedures: a systematic review. J Eur Acad Dermatol Venereol. 31(7). 1096-1110.
– Pain is a common side-effect of dermatological laser procedures. Non-invasive anaesthetic drugs and anaesthetic procedures can be used to provide pain relief and increase patient satisfaction and treatment efficacy. However, it remains unclear which method provides the best pain relief. The objective of this systematic review was therefore to assess the efficacy and safety of non-invasive anaesthetic methods during dermatological laser procedures.
– All of the studies had an unclear or high risk of bias, and the overall quality of evidence was rated as low. In general, active non-invasive anaesthetic methods seemed to provide favourable results compared to placebo or no anaesthesia, and topical anaesthetic drugs and pneumatic skin flattening (PSF) seemed to result in a better pain reduction than skin cooling. However, the current evidence is insufficient to provide recommendations for daily clinical practice.
– There is a need for more high-quality (head-to-head) RCTs. Future studies should also evaluate sex differences in pain perception, have uniformity with regard to validated pain measurement scales and address clinically significant differences in pain reduction besides statistically significant differences.
Greveling, K., et al. (2017). Comparison of lidocaine/tetracaine cream and lidocaine/prilocaine cream for local anaesthesia during laser treatment of acne keloidalis nuchae and tattoo removal: results of two randomized controlled trials. Br J Dermatol. 176(1). 81-86.
– To compare the efficacy of lidocaine/tetracaine cream and lidocaine/prilocaine cream in reducing self-reported pain during deeper dermal laser treatment of acne keloidalis nuchae (AKN) and tattoos.
– We conducted two randomized, double-blind, controlled clinical trials with intrapatient, split-lesion designs: study A included patients with AKN (n = 15); study B included patients with black tattoos (n = 15). The primary end point was the patients’ self-reported pain on a 10-cm visual analogue scale (VAS). Secondary objectives were the percentage of patients with adequate pain relief, willingness to pay €25 for the cream that provided the best pain relief and safety of the creams.
– In both studies, VAS scores were lower for lidocaine/prilocaine cream, with a mean VAS difference in study A of 1·9 and in study B of 0·6. In study A, adequate pain relief was achieved in 13% (n = 2) with lidocaine/tetracaine cream vs. 73% (n = 11) with lidocaine/prilocaine cream (P = 0·004), and in study B in 53% (n = 8) vs. 80% (n = 12), respectively (P = 0·289). In study A, 47% (n = 7) were willing to pay an additional €25 vs. 73% (n = 11) in study B. No serious adverse events occurred.
– Lidocaine/prilocaine cream under plastic occlusion is the preferred topical anaesthetic during painful laser procedures targeting dermal chromophores.
Heinen, E., et al. (2017). Do long-term tongue piercings affect speech quality? Logopedics Phoniatrics Vocology. 42(3). 126-132.
– … we analyzed the effect of tongue piercing on speech in a perception experiment. Samples of spontaneous speech and read speech were recorded from 20 long-term pierced and 20 non-pierced individuals (10 males, 10 females each). The individuals having a tongue piercing were recorded with attached and removed piercing. The audio samples were blindly rated by 26 female and 20 male laypersons and by 5 female speech-language pathologists with regard to perceived speech quality along 5 dimensions: speech clarity, speech rate, prosody, rhythm and fluency.
– We found no statistically significant differences for any of the speech quality dimensions between the pierced and non-pierced individuals, neither for the read nor for the spontaneous speech. In addition, neither length nor position of piercing had a significant effect on speech quality. The removal of tongue piercings had no effects on speech performance either. Rating differences between laypersons and speech-language pathologists were not dependent on the presence of a tongue piercing.
– People are able to perfectly adapt their articulation to long-term tongue piercings such that their speech quality is not perceptually affected
Hendren, N., et al. (2017, May 27). Vibrio vulnificus septic shock due to a contaminated tattoo. BMJ Case Rep.
– We present a case of Vibrio vulnificus septic shock and cellulitis in a patient with chronic liver disease that occurred after obtaining a leg tattoo with subsequent seawater exposure in the Gulf of Mexico.
– Despite aggressive initial treatment, the patient developed septic shock and died. This case highlights the association of chronic liver disease and high mortality associated with infections of V. vulnificus.
Henley, J. & Ramsey, M. (2017, June 30). Tattoo Lasers. Stat Pearls.
– Laser tattoo removal was first used in the late 1960s following the creation of the first laser, but removal often led to suboptimal results due to significant surrounding tissue destruction and scarring. It was not until the description of the theory of selective photothermolysis in the 1980s that exogenous tattoo pigment could be selectively targeted as a chromophore at specific wavelengths. According to this theory, the target chromophore must be heated quickly before it can cool. For optimal destruction, the pulse durations need to be shorter than the thermal relaxation time of the tattoo particle or the time that is required for the target to lose 50% of its heat. Due to the small size of the tattoo particles, rapid pulses of high heat at very short pulse durations in the nanosecond to picosecond range are required to prevent cooling of the particles. The thermal relaxation time of tattoo particles is thought to be less than ten nanoseconds. Lasers with Q-switched technology are capable of producing light pulses of short duration but with a peak power that is much higher than is achievable with continuous wave output. More recently, lasers of even shorter pulse duration have been developed, potentially offering better targeting of chromophores with less damage to surrounding tissue. Laser Devices: The type of laser and wavelength chosen for removal largely depends on the patient’s tattoo color and skin type. Q-switched (QS) lasers such as the QS Ruby, QS Nd: YAG, and QS Alexandrite until recently were the most effective devices for tattoo removal. However, picosecond lasers have quickly become the mainstay of treatment due to their superior efficacy and decreased treatment durations. Now there are picosecond 532-nm, 694-nm, 755-nm, and 1064-nm devices available to target a wide array of tattoo pigments. Patients with Fitzpatrick IV-VI (darker) skin types should be treated cautiously due to increased risk for hypopigmentation following treatment. Lasers that penetrate deeper into the dermis, such as the Nd: YAG 1064-nm laser, are associated with a decreased risk of epidermal damage and hypopigmentation in this patient population. Some chromophores for various laser wavelengths include: 532 nm – red, orange, yellow, brown. 694 nm – black, blue, green. 755 nm – black, blue, green. 1064 nm – black, blue. Colors that respond best to laser removal are black, brown, dark blue, and green, while the most difficult colors to remove are red, orange, yellow, and light blue.
Hutton, K., et al. (2017). Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal. Curr Probl Dermatol. 52. 124-131.
– Studies of satisfaction with tattoo removal outcomes by laser, rated by clients themselves, including qualitative aspects, are sparse. We studied long-term results and client satisfaction with tattoo removal by Q-switched YAG laser.
– Client-surgeon interaction during the full laser treatment course is a major determinant of client satisfaction. The client is in a dynamic state of mind and undergoes a change of opinion during a laser treatment course as a result of his/her experiences. In this continuous process of learning, expectations are changed from a state of high expectation before treatment to a more realistic state with acceptance of outcome. The laser surgeon shall be aware of his/her role as a tutor and prepare the client for a situation, where outcomes can be acceptable albeit not ideal.
Hutton, K., et al. (2017). Tattoo removal by Q-switched yttrium aluminium garnet laser: client satisfaction. J Eur Acad Dermatol Venereol. 31(5). 904-909.
– Tattoo removal by Q-switched yttrium aluminium garnet (YAG) lasers is golden standard; however, clients’ satisfaction with treatment is little known.
– One hundred and fifty-four tattoo removal clients who had attended the private clinic ‘Centre for Laser Surgery’, Hellerup, Denmark, from 2001 to 2013 completed a questionnaire concerning outcome expectations, level of pain experiences and satisfaction with tattoo removal. The laser surgeon and his team were blinded from data handling. The study design included a minimum 2-year postlaser treatment observation period from 2013 to 2015.
– Overall, clients were satisfied with their laser treatment; 85% assessed their treatment and results to be acceptable to superb, while 15% assessed their treatment and results to be inferior to unacceptable. Effectiveness relative to colour of tattoo on a scale from 0 (no effect) to 10 (complete removal) scored a mean of blue 9.5, black 9.4, yellow 8.9, red 8.8 and green 6.5. Clients were dissatisfied with green pigment remnants, which could mimic bruising. One hundred and twenty-nine clients (84%) experienced moderate to extreme pain during treatment. Twenty-eight (20%) developed minor scarring. There were many reasons for tattoo removal; e.g. stigmatisation (33%), conspicuousness (29%) and poor artistic quality (22%). One hundred and two clients had expected complete removal of tattoos without a blemish, expectations that were only partly fulfilled. During the treatment period, clients adjusted expectations and adapted more realistic views of outcomes.
– The majority of clients were satisfied with Q-switched YAG laser removal of tattoos despite high pretreatment expectations which were only partly met. The study supports YAG lasers for tattoo removal as acceptable therapy of today, with room for new approaches.
Imbernon-Moya, A., et al. (2017, February 23). Three-Dimensional Strawberry Tattoo. Actas Dermosifiliogr.
Imrigha, N., et al. (2017, May 2). Photobiomodulation therapy on wound treatment subsequent to Q-switched Nd: YAG laser tattoo removal in rat model. J Biophotonics.
– Q-switched Nd: YAG laser is the most effective laser for tattoo removal. Photobiomodulation (PBM) therapy is an alternative method applied to accelerate the wound healing. This paper investigated the effects of PBM therapy using 808 nm diode laser on tattooed skin after laser tattoo removal. Forty-five rats were selected and tattooed with black ink on their dorsal, and then distributed into three groups. G0 was received non-laser irradiation. G1 was treated by laser tattoo removal using 1064 nm with energy density of 3.4 J/cm2 without PBM therapy, while G2 was treated daily with PBM therapy using 808 nm diode laser of 5 J/cm2 after a single session of laser tattoo removal. The effects of tattoo removal and healing progress of the wound were analyzed using histological studies. Findings showed 808 nm laser promotes the healing process through enhancing epithelialization and collagen deposition. Moreover, PBM therapy stimulated immune cells to improve phagocytosis process for removing the tattoo ink fragments effectively. The PBM therapy treated group was capable of improving the healing process and increasing the quality of skin following the laser tattoo removal. It was also found that stimulation of cellular function by PBM therapy increased tattoo clearance efficiency.
Isik, S., et al. (2017). Severe Neck and Face Edema in an Adolescent-Delayed Hypersensitivity Reaction to Hair Dye. Pediatr Emerg Care. 33(6). 422-423.
– Here, a 15-year-old girl is presented, who developed a hypersensitivity reaction after first exposure to hair dye. She was found to have been sensitized to PPD before, through application of black henna tattoo.
Jakus, J. & Kailas, A. (2017). Picosecond Lasers: A New and Emerging Therapy for Skin of Color, Minocycline-induced Pigmentation, and Tattoo Removal. J Clin Aesthet Dermatol. 10(3). 14-15.
Jashnani, K., et al. The tattoo dilemma: Reading in between the ink. Indian J Pathol Microbiol. 60(1). 141-142.
Jibreal, H,., et al. (2017, June 28). Necrobiosis lipoidica following Q-switched laser tattoo removal. Australas J Dermatol.
Jones, M., et al. (2017). Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids. Dermatol Surg. 43(9). 1164-1169.
– Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT).
– Fifty ear keloids were treated with this method, age from 15 to 66 of which 14 were male and 35 female. Almost 30% of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence.
– Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.
Junco, P. (2017, March 20). Educational intervention about oral piercing knowledge among dental students and adolescents at schools. Int Dent J.
– Oral piercing can lead to complications and dentists are in a unique position to detect such complications. The purpose of this study was: (i) to assess the immediate and the long-term effects, on dental students, of a training programme about oral piercing knowledge; and (ii) to assess the immediate effect, on adolescents, of a single educational intervention session about oral piercing.
– Oral piercing educational intervention had a favourable impact on adolescents and dental students, particularly among those who were more involved in the learning process.
Karsai, S. (2017). Removal of Tattoos by Q-Switched Nanosecond Lasers. Curr Probl Dermatol. 52. 105-112.
– Tattoo removal by Q-switched nanosecond laser devices is generally a safe and effective method, albeit a time-consuming one. Despite the newest developments in laser treatment, it is still not possible to remove every tattoo completely and without complications. Incomplete removal remains one of the most common challenges. As a consequence, particular restraint should be exercised when treating multicoloured tattoos, and patients need to be thoroughly informed about remaining pigment. Other frequent adverse effects include hyper- and hypopigmentation as well as ink darkening; the latter is particularly frequent in permanent make-up. Scarring is also possible, although it is rare when treatment is performed correctly. It is becoming more widespread for laser operators to encounter allergic reactions and even malignant tumours in tattoos, and treating these conditions requires a nuanced approach.
Keester, D. & Sommerich, C. (2017). Investigation of musculoskeletal discomfort, work postures, and muscle activation among practicing tattoo artists. Appl Ergon. 58. 137-143.
– Tattoo artists are an understudied worker population with respect to investigation of work-related musculoskeletal (MSK) discomfort and associated risk factors. Results from one discomfort survey has been published; no analysis of worker biomechanics has been published. As such, a study was conducted to begin exposure assessment of tattoo artists to work factors that could result in MSK discomfort. Consistent with the prior survey, the current study showed an elevated prevalence of MSK discomfort. Twelve month discomfort prevalence exceeded 50% in the neck, shoulders, hands/wrists, and upper and lower back (range: 53-94%). Seventy-one percent of postures evaluated during 16 h of observation had total RULA scores of 5, 6, or 7 (investigation and changes are required soon or immediately). Static muscle activity levels in the left, right, or both upper trapezius muscles in each study participant exceeded the 2-5% MVE limit recommended in the literature.
Kim, Y., et al. (2017, April 24). Mohs Micrographic Surgery for a Red Tattoo Reaction. Dermatol Surg.
Kim, H., et al. (2017). Primary Cutaneous Aspergillosis after Tattoo Removal Using a 1,064-nm Q-Switched Nd:YAG Laser in an Immunocompetent Patient. Ann Dermatol. 29(2). 241-243.
Klement, K., et al. (2017). Extreme rituals in a BDSM context: The physiological and psychological effects of the « Dance of Souls. » Culture, Health, & Sexuality: An International Journal for Research, Intervention and Care. 19(4). 453-469.
– Participation in extreme rituals (e.g., fire-walking, body-piercing) has been documented throughout history. Motivations for such physically intense activities include religious devotion, sensation-seeking and social bonding. The present study aims to explore an extreme ritual within the context of bondage/discipline, dominance/submission and sadism/masochism (BDSM): the ‘Dance of Souls’, a 160-person ritual involving temporary piercings with weights or hooks attached and dancing to music provided by drummers. Through hormonal assays, behavioural observations and questionnaires administered before, during and after the Dance, we examine the physiological and psychological effects of the Dance, and the themes of spirituality, connectedness, transformation, release and community reported by dancers. From before to during the Dance, participants showed increases in physiological stress (measured by the hormone cortisol), self-reported sexual arousal, self-other overlap and decreases in psychological stress and negative affect. Results suggest that this group of BDSM practitioners engage in the Dance for a variety of reasons, including experiencing spirituality, deepening interpersonal connections, reducing stress and achieving altered states of consciousness.
Klimova, A., et al. (2017.) Tattoo-associated uveitis. Cesk Slov Ofalmol. 73(1). 30-33.
– The clinical case of tattoo-associated uveitis was first described by Lubeck and Epstein in 1952. Uveitis is accompanied by induration and hyperemia of tattoo skin, which can precede, follow or manifest simultaneously with uveitis. T
– Tattoo-associated uveitis should be remembered in differential diagnosis due to the growing interest in tattoo.
Kluger, N. & Bosonnet, S. (2017). Keloid occurring in a tattoo. Ann Dermatol Venereol. 144(6-7). 455.
Kluger, N. & Armingaud, P. (2017). Herpes simplex infection on a recent tattoo. A new case of « herpes compuctorum ». Int J Dermatol. 56(1). e9-e10.
Kluger, N. (2017). Tattooing and immunodepression: Caution is warranted also in organ transplant patients. Transpl Infect Dis. 19(3).
– Letter to editor with nicely worded summary as to previously reported life-threatening issues with body art and transplant/immunosuppressed patients
– Recommends patients discuss desire for new tattoos (especially if already tattooed & likely to get another one) with physician to determine best time for « green light » for new body art
– Also indicates recommendations for tattoo artists when dealing with patients of this type
Kluger, N. (2017). Body piercing and tattooing among French patients with bleeding disorders. Presse Med. 46(5). 538-540.
– Nice summary of a survey of patients with bleeding disorders (hemophilia, etc.) and their experiences with physicians, body artists, and preparations/complications
– Interestingly, a high percentage of people did not inform the body artist about their bleeding tendencies before tattooing or piercing
– Recommends discussion with physician and body artist pre-procedure to optimize chance for success and minimize complications
Kluger, N., et al. (2017). Tattooing and psoriasis: a case series and review of the literature. 56(8). 822-827.
– Koebner phenomenon (KP) affects from a quarter to a third of the patients with psoriasis and can occur on tattoos
– Six men and one woman with a median age of 36 ± 6.4 years old were included. Five disclosed a KP in a recent tattoo within days to 1 month after its completion. Fifteen additional cases were collected from the literature (8 men, median age 22 ± 8.2 years old). The delay of psoriasis flare-up after tattooing was rather short, from a few weeks to several months. We found a high variability in the clinical presentation with five clinical subtypes/profiles of psoriasis on tattoos. A possible confusion between « genuine » KP on tattoos and the coincidental occurrence of psoriasis patches on tattoos is possible in some cases of the literature.
– Koebner phenomenon on tattoos may occur in patients with psoriasis under various forms. The evolution is benign, and psoriasis is not a contraindication for tattooing, but patients need proper counseling before getting tattooed.
Kluger, N. (2017). Cutaneous Complications Related to Tattoos: 31 Cases from Finland. Dermatology. 233(1). 100-109.
– Thirty-one patients (16 men and 15 women, mean age 37.8) were included from 9 cities, mainly from Helsinki. Fifty-two percent (16/31) presented with an allergic tattoo reaction mainly against the red colour (75%, 12/16). Reactions were clinically polymorph ranging from scattered papules or nodules to complete infiltration of a colour. Lesions were itchy and sometimes painful. The reactions were lichenoid, granulomatous, pseudolymphomatous or less specific with a dermal lympho-histiocytic or plasmocytic infiltrate. Other diagnoses included tattoo blow-out (13%), melanoma within a tattoo, naevi within a tattoo (10% each), lichen planus (6%), granulomatous reaction with uveitis, sarcoidosis and dermatofibroma (3% each).
Kluger, N. (2017). National survey of health in the tattoo industry: Observational study of 448 French tattooists. Int J Occup Med Environ Health. 30(1). 111-120.
– The data regarding the health of professional tattooists is inexistent. Tattooists are usually heavily tattooed and exposed daily to body fluids and skin-to-skin contacts with customers, tattoo inks, solvents, allergens, irritants, and work for hours often in inadequate positions using vibrating tattoo machines. We analyzed the health status of active French professional tattooists.
– An observational self-reported Internet survey was performed among 448 tattooists who were members of the French Tattoo Union in November 2013.
– The main physical complaints were musculoskeletal: back pain (65%), finger pain (41.5%) and muscular pain (28.8%). Finger pain, back pain, muscular pain and carpal tunnel symptoms/tingling sensations on the fingers occurred among 88%, 61.5%, 68% and 84% of the cases after having started their activity (p < 0.001). Other chronic diseases, autoimmune diseases and cancers remained at a low level here.
– Professional tattooists have a high prevalence of musculoskeletal complaints about back pain due to repetitive movements, awkward postures and use of a vibrating tattoo machine. Tattooists have a unique environment that imply developing intervention and preventive strategies for them.
Lagrelius, M., et al. (2017, July 4). A population-based study of self-reported skin exposures and symptoms in relation to contact allergy in adolescents. Contact Dermatitis.
– 3115 adolescents questionaire concerning various skin exposures and related skin symptoms. Of these, 2285 were patch tested.
– The prevalences of self-reported piercing (55.4%), hair dyeing (50.1%) and related skin symptoms were high, particularly in girls. Piercing and itchy rash after contact with metal items were associated with increased risks of nickel.
– Adolescents are exposed to skin-sensitizing substances, for example because of piercing, hair dyeing, and tattooing. Such early-life skin exposure may lead to lifelong contact allergy and future allergic contact dermatitis and hand eczema.
Lambertini, M., et al. (2017). ‘Scaly’ tattoo reactions: is treatment mandatory? Clin Exp Dermatol. 42(3). 347-348.
Lee, H,. et al. (2017, May 31). Does the Sequence of Tattooing and Nipple Reconstruction Affect Nipple Projection? Ann Plast Surg.
– In nipple reconstruction, the maintenance of adequate projection is one of the most important and challenging aspects. However, no reports have evaluated whether tattooing after nipple reconstruction affects nipple projection. This study aimed to test our hypothesis that tattooing after reconstruction adversely affects nipple projection.
– These findings showed that the sequence of nipple reconstruction and tattooing had no significant effect on the projection of the reconstructed nipple. It is easier to tattoo homogeneously before nipple reconstruction because of the flat surface but more difficult to make a smooth areolar peripheral margin and circular areolar shape when reconstructing the nipple. The sequence of tattooing and nipple reconstruction can be determined according to esthetic and clinical considerations.
Lerche, C., et al. (2017, May 13). Red tattoos, ultraviolet radiation and skin cancer in mice. Exp Dermatol.
– Ultraviolet radiation (UVR) induces skin cancer. The combination of UVR and red tattoos may be associated with increased risk of skin cancer due to potential carcinogens in tattoo inks. This combination has not been studied previously.
– In conclusion, no spontaneous cancers were observed in skin tattooed with a red ink containing 2-anisidine. However, red tattoos exposed to UVR showed faster tumor onset regarding the third tumor, and faster growth rate of the second and third tumor indicating red ink acts as a cocarcinogen with UVR.
Lim, H. & Shin, H. (2017). Sensitive Determination of Volatile Organic Compounds and Aldehydes in Tattoo Inks. J Chromatogr Sci. 55(2). 109-116.
– As the popularity of body art including tattoo ink has increased, the safety associated with it has become an important interest. In this study, twenty volatile organic compounds (VOCs) and two aldehydes in tattoo inks were identified and quantified.
– Our analytical results represent solvents used intentionally or non-intentionally in tattoo inks, and thus they may provide important information for national regulation.
Lorgeou, A., et al. (2017, July 31). Comparison of two picosecond lasers to a nanosecond laser for treating tattoos: a prospective randomized study on 49 patients. J Eur Acad Dermatol Venereol.
– Q-switched nanosecond lasers demonstrated their efficacy in treating most types of tattoos but complete disappearance is not always achieved even after performing numerous laser sessions. Picosecond lasers are supposed to be more efficient in clearing tattoos than nanosecond lasers but prospective comparative data remain limited.
– A total of 49 patients were included. Professional tattoos represented 85.7%, Permanent makeup 8.2% and non-professional tattoo 6.1%. The majority were black or blue and 10.2% were polychromatic.
– A reduction of 75% or more of the color intensity was obtained for 33% of the tattoos treated with the picosecond lasers compared to 14% with the nanosecond laser (p=0.008). An improvement superior to 75% was obtained in 34% monochromic black or blue tattoos with the picosecond lasers compared to 9% for the nanosecond laser. Only 1 of the 5 polychromic tattoos achieved more than 75% of improvement with the two types of laser.
– Our results show a statistically significant superiority of the picosecond lasers compared to the nanosecond laser for tattoo clearance. However, they don’t show better efficacy for polychromic tattoos and the difference in terms of side effects were also minimal with a tendency of picosecond lasers to be less painful.
Lu, C., et al. (2017). Bilateral diffuse lamellar keratitis triggered by permanent eyeliner tattoo treatment: A case report. Exp Ther Med. 14(1). 283-285.
– Diffuse lamellar keratitis (DLK) is a sterile inflammation of the cornea, which may occur after laser-assisted in situ keratomileusis (LASIK) surgery. Little is known about the association of DLK with permanent eyeliner tattoo. The present case report describes the case of a 37-year-old Chinese woman who developed severe foreign body sensation in both eyes 1 week after receiving bilateral permanent eyeliner tattoo treatment. The patient had received bilateral LASIK surgery 10 years previously.
– To our knowledge, this is the first case report describing a case of late-onset of DLK that was triggered by permanent eyeliner tattoo. Doctors should be aware of the diagnosis and treatment of this complication associated with the application of permanent eyeliner tattoo as the popularity of this cosmetic procedure increases.
Luetkemeier, M., et al. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Med Sci Sports Exerc. 49(7). 1432-1436.
– The purpose of this study was to compare the sweat rate and sweat Na concentration of tattooed versus nontattooed skin.
– Tattooed skin generated less sweat and a higher Na concentration than nontattooed skin when stimulated by pilocarpine iontophoresis.
Malca, N., et al. (2017). Dealing with tattoos in plastic surgery. Tattoo removal. Ann Chir Plast Esthet. 62(2). e15-e21.
– Not only has tattooing been socially performed for thousands of years, but it has also been part and parcel of medical practice since antiquity. In our day and age, plastic surgeons are ever more frequently compelled to deal with tattooing – and with tattoo removal procedures, as well. While the process itself may appear harmless, it is not without risk and necessitates use of suitable tools and management by expert hands.
Malki, S., et al. (2017). Cutaneous T pseudolymphoma on the red pigmented areas of a tattoo. Int J Dermatol. 56(8). e172-e173.
Millan-Cavetano, J., et al. 92017, May 17). Treatment of red tattoo reaction using CO2 laser. Lasers Med Sci.
Mitchell, L., et al. (2017, January 19). Tattoo Trouble. BMJ. 356.
Mori, W., et al. (2017). Tattoo Artists’ Approach to Melanocytic Nevi. JAMA Dermatol. 153(4). 328-330.
Moulton, L. & Jernigan, A. (2017, February 19). Management of Retained Genital Piercings: A Case Report and Review. Case Rep Obstet Gynecol.
– The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing. Local anesthetic was injected into the periclitoral skin and a small superficial vertical incision was made to remove the ball of the retained barbell safely. In conclusion, among patients with retained genital piercing, outpatient removal of embedded jewelry is feasible. While the practice of female genital piercing is not regulated, piercing of the glans of the clitoris is associated with increased injury to the nerves and blood supply of the clitoris structures leading to future fibrosis and diminished function compared to piercing of the clitoral hood.
– While retained or embedded jewelry is reported as a known complication of genital piercings, there is little published information about patients who are at risk and management strategies. To our knowledge, this is the first report detailing the removal of an embedded clitoral piercing.
– Retained jewelry is a known complication of genital piercings, but there is a paucity of published information on how to manage this problem. The best removal method in these delicate and sensitive areas must be tailored to the patient, the embedded object, and the physician’s skill set. In this case, removal was performed safely in an outpatient setting avoiding the morbidity of general anesthesia and the expense of operative management. As the popularity for genital piercings increases, clinicians should be prepared to handle the potential complications.
Muller, C., et al. (2017). Socio-epidemiologic aspects and cutaneous side effects of permanent tattoos in Germany – Tattoos are not restricted to a specific social phenotype. Dermatoendocrinol. 9(1).
– More and more people of all age classes have a tattoo. Intriguingly, there are multiple prejudices in the general population and published data that concern tattooed persons, such as being criminals, having a low education, being alcohol or drug abusers, or more risky in their life style.
– We interviewed 426 participants with already existing tattoos and 20 participants just before getting a new tattoo by using an online questionnaire. The participators were asked about socio-epidemiologic aspects of tattoos in general and special aspects of their own tattoo(s) in particular.
– Tattoos are interesting for people seeking popular body art, esp. university graduates and financially-secure individuals. 446 persons participated in this study. Most of the persons were female with a mean age of 35…. 93.5% of the participants did not want a tattoo removal. Intriguingly, most of the participants experienced no career problems related to the tattoo(s).
– The present data shows that common tattooed persons are not low educated criminals with any drug or alcohol abuse or with risky life style. Nowadays being tattooed encompasses a kind of body art and displays a certain kind of lifestyle habit.
Naeini, F., et al. (2017). Looking beyond the cosmetic tattoo lesion near the eyebrow: Screening the lungs. J Postgrad Med. 63(2). 132-134.
– We report a 45 year-old patient with history of dyspnea and mild cough since two years who had subsequently developed reddish, scaly lesions in her 15-year old tattoo done near her right eyebrow. Skin biopsy of the tattoo lesion revealed cutaneous sarcoidosis which led to further investigations and a diagnosis of pulmonary sarcoidosis. The present case highlights the fact that cutaneous sarcoidosis can develop in a long-standing tattoo. Also such a patient should be screened for systemic sarcoidosis disease.
Naga, L. & Alster, T. (2017). Laser Tattoo Removal: An Update. Am J Clin Dermatol. 18(1). 59-65.
– Tattoo art has been around for thousands of years in every culture and is currently flourishing in all age groups, social classes, and occupations. Despite the rising popularity of tattoos, demand for their removal has also increased. While various treatments, including surgical excision, dermabrasion, and chemical destruction have historically been applied, over the past 2 decades, lasers have revolutionized the way tattoos are treated and have become the gold standard of treatment. To achieve optimal cosmetic outcome of treatment, lasers emitting high energies and short pulses are required to adequately destroy tattoo ink. We review the history of laser tattoo removal, outlining the challenges inherent in developing lasers that can most effectively remove tattoo particles while safely protecting skin from unwanted injury.
Napolitano, M., et al. (2017, May 16). Skin diseases and tattoos: a five-year experience. G Ital Dermatol Venereol.
– A retrospective study analyzing records data of patients attending the Department of Dermatology, University of Naples « Federico II » during 2011-2015 was performed. All cases of tattoo related or closely located dermatitis were selected.
– We observed 19 patients (mean age: 26.4 year-old) showing cutaneous conditions related to the practice of tattooing. Allergic contact dermatitis was reported as the most common cutaneous disease linked to tattooing (31.6%), followed by granulomatous reactions (26.3%). These data are consistent with those already reported in literature.
– Our results highlight the need to develop detailed regulations regarding tattoos practice, used materials, as well as execution procedures in order to limit the outbreak of tattooing related skin diseases.
O’Beirne, S., et al. (2017). The lady with the dragon tattoo. Ir J Med Sci. 186(1). 157-160.
– A 35-year-old Caucasian female with multiple tattoos presented with a 5-week history of tenderness of the black dye in a tattoo depicting a dragon.
– Sarcoidal tattoo reactions in those without systemic sarcoidosis are a rare occurrence, and their presence should prompt a search for systemic involvement. The accurate identification of skin involvement in sarcoidosis is important, as it tends to occur early in the course of disease, and the skin is a readily accessible site for biopsy, allowing for prompt diagnosis.
Ogawa, R. (2017). Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. Int J Mol Sci. 18(3).
– Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scars are due to injury to this skin layer and the subsequent aberrant wound healing therein.
Ormerod, E., et al. (2017). Allergic contact dermatitis caused by resorcinol following a temporary black henna tattoo. Contact Dermatitis. 77(3). 187-188.
Ortiz, J., et al. (2017). Para-phenylenediamine allergic contact dermatitis due to henna tattoos in a child and adolescent population. An Pediatr (Barc). 86(3). 122-126.
– Almost half (49.7%; (361 cases) of the children had one or more positive patch test findings, with 4.7% (34) being allergic to PPDA. Mean age of patients allergic to PPDA was 12.4 years, and 44.2% were male. There were 2 cases (5.9%) of atopic dermatitis. Of the positive reactions, 73.5% were considered to be current clinically relevant. The sensitisation origin was a Henna tattoo in 50% of cases.
– PPDA sensitisation is relatively common in the child and adolescent population. The most frequent origin is the performing of Henna tattoos adulterated with PPDA. Adolescents are at the higher risk of developing ACD due to Henna tattoos. Henna tattooing should be strongly discouraged in children.
Pandya, V., et al. (2017). Tattoo-associated uveitis with choroidal granuloma: A rare presentation of systemic sarcoidosis. Retin Cases Brief Rep. (11(3). 272-276.
– A 30-year-old man presented with headaches, ocular pain, photophobia, and blurred vision. He was found to have significant skin inflammation, predominantly involving areas of tattoos…. He was diagnosed with systemic sarcoidosis.
– The authors report another rare case of tattoo-associated uveitis, in which inflammation is limited to tattooed skin and the uvea. This uncommon presentation may prove informative in elucidating the pathogenesis of systemic sarcoidosis.
Painsi, C. & Lange-Asschenfeldt, B. (2017), Image Gallery: Pink papules within a tattoo linked to Mycobacterium chelonae infection. Br J Dermatol. 177(1).
Panfili, E., et al. (2017). Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature. Int J Environ Res Public Health. 14(4).
– Because of its molecular characteristics, PPD can induce skin sensitization that may cause various clinical manifestations with successive exposures, among which the most common is allergic contact dermatitis (ACD). This report describes two paediatric cases of PPD sensitization and ACD after the exposure to TBHT and summarizes the literature on this emerging clinical problem.
Perez-Lopez, I., et al. (2017). Tattoo in 3 dimensions, foreign body granuloma. Med Clin (Barc). 148(6). e35.
Pinto, F., et al. (2017). Neodymium-doped yttrium aluminium garnet (Nd:YAG) 1064-nm picosecond laser vs. Nd:YAG 1064-nm nanosecond laser in tattoo removal: a randomized controlled single-blind clinical trial. Br J Dermatol. 176(2). 457-464.
– For decades, nanosecond lasers (NSLs) have been used to remove tattoos. Since 2012, pulses of picosecond lasers (PSLs) have been available for tattoo removal. Based on a few observational studies, the claim has been made that PSLs are considerably more effective while showing fewer side-effects in comparison with NSLs.
– Twenty-one patients with 30 black tattoos were treated with PSL and NSL in a split-study design in two sessions at intervals of 6 weeks.
– The average clearance overall as evaluated showed no statistical difference between NSL and PSL (P = 1·00). Using a visual analogue scale (0 = no pain, 10 = maximum pain), a value of 3·8 ± 1·0 was reported for the PSL, which was statistically different from NSL (7·9 ± 1·1, P < 0·001). Transient side-effects were observed, as well as hypo- and hyperpigmentation, but there was no statistically significant difference between PSL and NSL.
– After two treatments of black tattoos with a neodymium-doped yttrium aluminium garnet laser (1064 nm), the use of picosecond pulses does not provide better clearance than nanosecond pulses. However, pain is less severe when using a PSL.
Reinhard, R., et al. (2017, February 21). Recurrent tattoo reactions in a patient treated with BRAF and MEK inhibitors. J Eur Acad Dermatol Venereol.
Reiter, O., et al. (2017). Erratum to: Picosecond lasers for tattoo removal: a systematic review. Lasers Med Sci. 32(2). 483.
Ross, E. (2017). The picosecond revolution and laser tattoo treatments: are shorter pulses really better? Br J Dermatol. 176(2). 299-300.
Ross, N., et al. (2017). Eruptive Milia Within a Tattoo: A Case Report and Review of the Literature. J Drugs Dermatol. 16(6). 621-624.
– Of the many tattoo reactions the most common are allergic, granulomatous, lichenoid, photosensitive, pseudolymphomatous, and infectious. Eruptive milia are a rare complication with only three prior reports in the English literature. A 19-year-old African American female presented with tiny, white papules confined within the margins of a tattoo. She denied trauma or associated symptoms at the site. Biopsy demonstrated deposits of black granular material within the dermis and a small infundibular cyst; a diagnosis of eruptive milia within tattoo was made.
– Given its rarity, it is important to recognize the presentation of this disorder as other tattoo reactions require more aggressive management.
Santosh, A. & Reddy, B. (2017). Oral Mucosal Infections: Insights into Specimen Collection and Medication Management. Dent Clin North Am. 61(2). 283-304.
– Oral mucosal infections appear as localized or generalized lesions. Symptoms range from almost unnoticeable lesions to severe pain. Systemic disease, age, immunocompromised condition, and medication use are common causes. Local causes include dentures, poor oral hygiene, traumatized epithelium, ulcerations, dentures, implants, oral piercing, and reduced salivary secretion…
Sasaki, K., et al. (2017). Type 2 Minocycline-induced hyperpigmentation successfully treated with the novel 755 nm picosecond alexandrite laser – a case report. Laser Ther. 26(2). 137-144.
– Minocycline therapy for acne vulgaris is associated with the occasional induction of various types of unsightly and often persistent hyperpigmentation, which is frequently resistant to hydroquinone treatment. Pigment-specific lasers have achieved some success with multiple treatment sessions. Recently, the picosecond domain 755 nm alexandrite laser (ps-Alex) has attracted attention in tattoo removal. The present study reports on the successful treatment, in a single ps-Alex session, of minocycline-associated pigmentation.
– Our results in this single case strongly suggest that the novel 755-nm ps-Alex laser is both safe and very effective for the treatment of type 2 minocycline-induced hyperpigmentation even in PIH-prone type IV Asian skin.
Schmitz, I, et al. (2017). Squamous cell carcinoma in association with red tattoo. J Dtsch Dermatol Ges. 15(1). 98-100.
– Although tattoos have become exceedingly popular in recent years, only few cases of severe reactions leading to malignant transformation have been reported in the literature. This stands in contrast to the virtually innumerable number of tattoos worldwide. The composition of tattoo dyes is highly variable, and even the same colors may contain different compounds. The objective of our study was to investigate in what way tattoo dyes may potentially trigger skin cancer.
– We report the rare case of a 24-year-old woman who – seven months after getting a tattoo on the back of her foot – developed a squamous cell carcinoma in close proximity to the red dye used.
– While the tattoo dye primarily consisted of barium sulfate, traces of Al, S, Ti, P, Mg, and Cl were also detected. The analysis showed pigment granules of varying sizes. In rare cases, tattoo inks may have carcinogenic effects, which appear to be multifactorial.
Sepehri, M., et al. (2017). Search for Internal Cancers in Mice Tattooed with Inks of High Contents of Potential Carcinogens: A One-Year Autopsy Study of Red and Black Tattoo Inks Banned in the Market. Dermatology. 233(1). 94-99.
– Tattoo ink stock products often contain potential carcinogens, which on large-scale population exposure may be clinically relevant. The aim of this autopsy study in mice was to screen major organs for clinical and subclinical cancers.
– The black and red inks were both stock products banned on the Danish market due to the measured contents of potential carcinogens; benzo(a)pyrene and 2-anisidine, respectively.
– Despite extensive tattoos with 2 banned inks, the long-term observation in mice showed no internal cancers nor was the combination of carcinogen and UVR associated with cancer. Lack of observed malignancy might be explained by the fact that tattooing is only a single dose exposure. Registered data on carcinogens relies on repeated or chronic exposures. The study does not support the hypothesis that tattooing causes cancer.
Sepehri, M., et al. (2017). Tattoo Pigments Are Observed in the Kupffer Cells of the Liver Indicating Blood-Borne Distribution of Tattoo Ink. Dermatology. 233(1). 86-93.
– Tattoo pigments are deposited in the skin and known to distribute to regional lymph nodes. Tattoo pigments are small particles and may be hypothesized to reach the blood stream and become distributed to peripheral organs. This has not been studied in the past. The aim of the study was to trace tattoo pigments in internal organs in mice extensively tattooed with 2 different tattoo ink products.
– The study demonstrated black and red tattoo pigment deposits in the liver; thus, tattoo pigment distributed from the tattooed skin via the blood stream to this important organ of detoxification. The finding adds a new dimension to tattoo pigment distribution in the body, i.e., as observed via the blood in addition to the lymphatic pathway.
Sepehri, M. & Jorgensen, B. (2017). Surgical Treatment of Tattoo Complications. Curr Probl Dermatol. 52. 82-93.
– With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented.
Sepehri, M., et al. (2017). Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material. Dermatology. 232(6). 679-686.
– This is a consecutive study of patients with tattoo complications, diagnosed in the « Tattoo Clinic » at Bispebjerg University Hospital in Copenhagen, Denmark, from 2008 to 2015, based on clinical assessment and histology. From the overall group of 494 tattoo complications in 406 patients, 92 reactions in 72 patients showed a papulo-nodular pattern studied for local and systemic sarcoidosis, since sarcoidosis is expected to be nodular.
– Black tattoos with papulo-nodular reactions should be seen as markers of sarcoidosis. Papulo-nodular reactions may, as triggers, induce widespread reactions in other black tattoos – a « rush phenomenon » – depending on individual predisposition. Sarcoidosis is estimated to be 500-fold increased in papulo-nodular reactions compared to the prevalence in the general population, and the association with black tattoos is strong.
Serup, J. (2017). Diagnostic Tools for Doctors’ Evaluation of Tattoo Complications. Curr Probl Dermatol. 52. 42-57.
– Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentarium of standard tests. Diagnosis primarily builds on patient history, objective clinical examination, and punch biopsy, supplemented with microbiology testing, ultrasound scanning, and clinical photography.
Serup, J. (2017). Medical Treatment of Tattoo Complications. Curr Probl Dermatol. 52. 74-81.
– Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the ‘moist wound’ principle using plastic film, hydrocolloids, silver dressing, and compression.
– A warning against the use of lactic acid and other caustic chemicals for tattoo removal is given, since such chemicals and commercial products cannot be dosed properly and very often result in disfiguring scarring.
Serup, J. (2017). How to Diagnose and Classify Tattoo Complications in the Clinic: A System of Distinctive Patterns. Curr Probl Dermatol. 52. 58-73.
– Tattoo complications represent a broad spectrum of clinical entities and disease mechanisms. Infections are known, but chronic inflammatory reactions have hitherto been inconsistently reported and given many interpretations and terms. A clinical classification system of distinct patterns with emphasis on inflammatory tattoo reactions is introduced. Allergic reactions prevalent in red tattoos and often associated with azo pigments are manifested as the ‘plaque elevation’, ‘excessive hyperkeratosis’, and ‘ulceronecrotic’ patterns. The allergen is a hapten. Nonallergic reactions prevalent in black tattoos and associated with carbon black are manifested as the ‘papulonodular’ pattern. Carbon black nanoparticles agglomerate in the dermis over time forming foreign bodies that elicit reactions. Many black tattoos even develop sarcoid granuloma, and the ‘papulonodular’ pattern is strongly associated with sarcoidosis affecting other organs. Tattoo complications include a large group of less frequent but nevertheless specific entities, i.e. irritant and toxic local events, photosensitivity, urticaria, eczematous rash due to soluble allergen, neurosensitivity and pain syndrome, lymphopathies, pigment diffusion or fan, scars, and other sequels of tattooing or tattoo removal. Keratoacanthoma occurs in tattoos. Carcinoma and melanoma are rare and occur by coincidence only. Different tattoo complications require different therapeutic approaches, and precise diagnosis is thus important as a key to therapy. The proposed new classification with characteristic patterns relies on simple tools, namely patient history, objective findings, and supplementary punch biopsy. By virtue of simplicity and broad access, these methods make the proposed classification widely applicable in clinics and hospitals. The system is reported to the 11th revision of the WHO diagnosis classification used as international standard.
Serup, J. (2017). From Technique of Tattooing to Biokinetics and Toxicology of Injected Tattoo Ink Particles and Chemicals. Curr Probl Dermatol. 52. 1-17.
– Tattoo colourants are colourful nano- and microparticles, which are practically insoluble and thus permanent once installed in the dermis by the tattooist. Tattoo ink also has soluble ingredients and contaminants. Pigments can distribute via the lymph and possibly also directly to the blood, and a minute fraction may over time undergo metabolic breakdown and as hapten(s) induce allergic reactions of red tattoos. Carbon black of black tattoos has a tendency to agglomerate and form larger bodies that can elicit foreign body reactions in black tattoos and even granuloma formation with overlap to sarcoidosis in the clinic. Very little is known about the biokinetics and safety profile of the many tattoo pigments in use, and no specific pigment-related chemical of tattoo ink causing identified adverse reactions in humans has been depicted. Inks have many ingredients and contaminants.
– Controlling the safety of tattoo inks by banning potentially critical chemicals hitherto has been unsuccessful due to lacking documentation of clinical and epidemiological relevance and because the tattoo industry is already internationally established, free, and in the ownership of the people. Doctors treating patients with tattoo complications consequently have a key role in identifying risk situations and local outbreaks, which needs clarification, therapy, and the intervention of authorities. In the treatment of complications, as seen in general practice and in other specialties, basic insight into the fate of tattoo pigments in the body is necessary. Tattoo complications are complicated and facetted with many entities and disease mechanisms; they are a new subspecialty in medicine and dermatology.
Serup, J. (2017). Tattoo Infections, Personal Resistance, and Contagious Exposure through Tattooing. Curr Probl Dermatol. 52. 30-41.
– Bacterial infection of tattoos remains a common complication. Pyogenic bacteria can cause infections shortly after the tattoo is made. Severity of infection varies from minor to major, ultimately with life-threatening septicemia.
– Doctors have a role not only in treating tattoo infections but also in reporting cases to the competent authority in their country to support the monitoring of tattoo infections at any time, as an instrument for the authority to detect local outbreaks of tattoo infections early and prevent that new tattoo customers become infected. It is a potential risk of the future that new and very aggressive bacteria not seen in the past may unexpectedly show up in the tattoo scene.
Serup, J. (2017). Atlas of Illustrative Cases of Tattoo Complications. Curr Probl Dermatol. 52. 139-229.
– Tattoos, and tattoo complications as well, are colorful and visually flashy. A clinical outlook provides important clues to diagnosis by pattern recognition. This atlas,which is a report of 79 case illustrations, is made as a practical tool and vade mecum for the clinician.
– This atlas is a tutorial in modern medical and surgical treatments of tattoo complications.
Serup, J. (2017). Individual Risk and Prevention of Complications: Doctors’ Advice to Persons Wishing a New Tattoo. Curr Probl Dermatol. 52. 18-29.
– Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual’s tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person’s health condition, level of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare.
– A campaign called ‘Tattoo – know your risk’ is presented with detailed fact sheets about tattoos, tattoo problems, how to reduce risk, and a checklist for the tattoo customer before decision-making. The sheets with keynote information are useful aids for doctors giving advice to persons curious about acquiring a tattoo.
Serup, J. & Baumler, W. (2017). Guide to Treatment of Tattoo Complications and Tattoo Removal. 52. 132-138.
– Clinicians in the fields of general medicine, dermatology, and plastic surgery are in their work now and then confronted with tattoo complications. Recognizing the rather few important diagnostic groups and urgencies, the medical ‘decision tree’ of treatment becomes quite simple. Acute conditions are dominated by bacterial infections needing antibiotic treatment. Systemic infection is a matter of urgency and requires intravenous treatment in a hospital without delay to prevent septic shock. Inflammatory reactions are a real challenge.
– Tattoo complications also include many rare but specific entities, which require individual treatment depending on the case and the disease mechanism. Removal of tattoos in individuals regretting their tattoo is performed using Q-switched nanosecond lasers and the recently introduced picosecond lasers. In view of the various tattoo pigments with different absorption spectra and the limited number of laser wavelengths, it is difficult to predict treatment outcome, and it is recommended to pretreat small test spots. Black and red colors are removed best, while other colors are difficult. Removal of large tattoos, especially when multicolored, is hardly achievable and not recommended. Clients often have unrealistic expectations, and informed consent and dialogue between the client and the laser surgeon before and during a treatment course is important since the client shall know the risk that removal can be unsuccessful, with complications and even disfiguring leading to regret at the end.
Shashikumar, B., et al. (2017). Hypersensitive Reaction to Tattoos: A Growing Menace in Rural India. Indian J Dermatol. 62(3). 291-296.
– Fifty cutaneous allergic reactions were diagnosed among 39 patients. Mean age of subjects was 22 years and mean duration before the appearance of lesion was 7 months. Common colors associated with reactions were red (53.9%), black (33.3%), green (5.1%), and multicolor (7.7%). Itching was the predominant symptom. Skin lesions mainly consisted of lichenoid papules and plaques, eczematous lesions, and verrucous lesions. Lichenoid histopathology reaction was the most common tissue allergic reaction.
– Increasing popularity of tattooing among young people has predisposed to parallel increase in adverse reactions. Red pigment is most common cause of allergic reaction in the present study, and lichenoid reaction is the most common reaction.
Silk, H. & Kwok, A. (2017). Addressing Adolescent Oral Health: A Review. Pediatr Rev. 38(2). 61-68.
– Oral health is one of the most unmet health care needs of adolescents. Oral disease can have a profound effect on overall health, including pain, missed school, heart disease, and even death. Adolescents have specific needs pertaining to oral health in addition to the usual lifelong issues of caries management, sports injury prevention, and dental referrals. Teen years are a higher risk time for oral piercings, increased sugar intake, nicotine initiation, and orthodontic considerations. Adolescents need a unique approach to motivate them about their oral health issues. This is particularly important because lifelong health habits are created during these formative years, and prevention opportunities for sealants and varnish are only available at this age.
Soran, A., et al. (2017, July 6). The importance of tattoo pigment in sentinel lymph nodes. Breast Dis.
– The presence of pigment in axillary lymph nodes (LN) secondary to migration of tattoo ink can imitate the appearance of a blue sentinel lymph node (SLN) on visual inspection, causing the operator to either miss the true SLN or excise more than is needed.
– Patients were retrospectively reviewed from medical records and clinicopathologic data was collected. A total of 52 LNs were retrieved from 15 patients for sentinel mapping and 29 of them had tattoo pigmentation on pathologic evaluation.
– Of those 29 SLNs, 2 of them (6.9%) were pigmented, but did not contain either blue dye or Tc-99m (pseudopigmented SLN). Two (3.8%) SLNs were positive for metastasis; both of these had either blue dye or Tc99m uptake, and 1 demonstrated tattoo pigment in the node.
– In this cohort of patients with ipsilateral tattoos, removed more LNs lead to unnecessary excision which may important for increasing the risk of arm morbidity from SLN biopsy. However, the presence of tattoo pigment did not interfere with understaging for axillary mapping and it did not effect of pathological identification of SLNs positivity.
Stirn, A. & Zannoni, R. (2017, July 25). Body modifications and sexual health : Impact of tattoos, body piercing and esthetic genital plastic surgery on the sexual health of women and men Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz.
– The present paper addresses the psychological impact of body modifications (e.g. tattoos, body piercing and esthetic genital plastic surgery) on the sexual health of individuals and refers to past and present research insights. Body modifications are understood as invasive interventions on the human body, especially interventions on the human skin which result in (semi-)permanent changes. Tattoos and body piercing (in particular genital piercing) positively affect the sexual satisfaction and the sexual appeal of men and women but there is a controversial association with high risk sexual behavior. Moreover, this article focuses on esthetic genital plastic surgery based on the increasing interest and insights of the impact on female genital self-perception and sexual behavior.
Sun, J., et al. (2017, August 7). Evaluation of metabolism of azo dyes and their effects on Staphylococcus aureus metabolome. J Ind Microbiol Biotechnol.
– Dyes containing one or more azo linkages are widely applied in cosmetics, tattooing, food and drinks, pharmaceuticals, printing inks, plastics, leather, as well as paper industries. Previously we reported that bacteria living on human skin have the ability to reduce some azo dyes to aromatic amines, which raises potential safety concerns regarding human dermal exposure to azo dyes such as those in tattoo ink and cosmetic colorant formulations.
– In summary, this study provided novel information regarding azo dye metabolism by the skin bacterium, the effects of azo dyes on the bacterial cells and the important role on the toxicity and/or inactivation of these compounds due to microbial metabolism.
Tammaro, A., et al. (2017). Aminoazobenzene in tattoo: another case of allergic contact dermatitis. Int J Dermatol. 56(4). e79-e81.
Tanner, S. & Menzies, S. (2017, January 5). Cutaneous sarcoid granulomas within a cosmetic tattoo. 356.
Tomazevic, T., et al. (2017). Occurrence of Dental Injuries and Periodontal Complications in Tongue-piercing Jewellery Users. Oral Health Prev Dent. 15(3). 293-297.
– Tongue piercing (TP) has been gaining in popularity, mainly among adolescents and young adults, and there has been a corresponding increase in reports of dental injury and adverse effects on periodontal tissue due to TP jewellery. The purpose of this study was to assess the type and prevalence of dental injury and periodontal complications in a group of Slovenian adolescents and young adults with TP in comparison with a control group.
– This case-control study included 17 subjects with TP (study group) and 28 subjects without TP (control group). Subjects were clinically examined for dental injuries, as classified according to Andreasen. Periodontal complications were evaluated using an estimation of clinical attachment loss (CAL) and gingival recession (GR).
– Subjects with TP had 12.2 higher odds of dental injury compared with subjects without TP. Enamel fractures were more prevalent in the study group. Frequencies of other dental injuries in the two groups were similar. GR was significantly associated with TP while differences in CAL between the groups were not statistically significant.
Trinh, S., & Angarone, M. (2017). Purpureocillium lilacinum tattoo-related skin infection in a kidney transplant recipient. Transpl Infect Dis. 19(3).
– Purpureocillium lilacinum is an emerging pathogenic mold among immunocompromised hosts that causes cutaneous infections related to skin breakdown. We present the first reported case of P. lilacinum tattoo-related skin infection, to our knowledge. A kidney transplant recipient recently treated for acute cellular rejection presented with skin papules overlying a tattoo.
Vanarase, M., et al. (2017, April 10). Comparison of Q-switched Nd:YAG laser alone versus its combination with ultrapulse CO2 laser for the treatment of black tattoo. 1-7.
– Sixty patients with black tattoo were randomized into two groups viz., group A and group B. Group A was treated with QS Nd:YAG laser (1064 nm) alone, and group B received combination of ablative ultrapulse CO2 followed by fixed-dose QS Nd:YAG laser (1064 nm), at 6-week interval for a maximum of 6 sittings. After each sitting, 3 independent physicians noted percentage of improvement that was evaluated using visual analogue scale (VAS) and grading system for tattoo ink lightening (TIL).
– Combination laser (group B) showed statistically significant improvement in mean VAS score in the last 2 noted visits as compared to 1st session (p < 0.007, p < 0.001) and TIL mean score in last three noted visits as compared to 1st session (p < 0.008, p < 0.020, and p < 0.004). There was no statistically significant difference in the side effect profile of both the groups.
– For refractory professional tattoos, combination of ultrapulse CO2 laser and QS Nd:YAG laser is superior to QS Nd:YAG laser alone.
Van Hoover, C., et al. (2017, August 14). Body piercing: Motivations and implications for health. J Midwifery Women’s Health.
– Body piercing has evolved from a behavior once considered extreme to an accepted choice among the general population. Earlobe piercing is so common that it is now considered a normative behavior. The motivations for choosing body piercing have changed and are associated with piercing site and number of piercings chosen by the individual. Meanings ascribed to body piercing were traditionally related to enhanced sexual desirability and experience, but now range from the innocuous, such as a fashion statement, to the risk laden, such as non-suicidal self-injury. Professional piercers are the primary providers of piercing services, and people will first turn to their professional piercer for advice when complications of the site arise, thus delaying entry into needed health care. Health care providers are often perceived as uninformed, dismissive, and biased against individuals, who are pierced particularly those with multiple piercings and piercings in intimate areas of the body. Common complications of piercing include infection, bleeding, and problems relating to tissue trauma and scarring, and are reported by nearly 50% of individuals who are pierced. Metal allergies can develop as a result of piercing, making the type of jewelry used for body adornment an important consideration. Additionally, management of the piercing site becomes critical under certain conditions, such as during pregnancy and birth, lactation, or surgery. This article provides information supporting midwives and other health care providers to offer anticipatory guidance and health care services in a nonjudgmental and supportive manner to individuals choosing body piercing.
Waton, J., et al. (2017). A putative case of allergic contact dermatitis caused by a jagua tattoo. Contact Dermatitis. 76(5). 296-297.
Wegner, T., et al. (2017). Ulcerative plaque within a tattoo in a 49-year-old man. J Dtsch Dermatol Ges. 15(6). 678-681.
Weiss, R., et al. (2017). Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles. Lasers Surg Med. 49(1). 40-44.
– Forty female subjects presenting with wrinkles from photo-damage were enrolled in an IRB approved study. Subjects received four picosecond diffractive lens array treatments to the full face at 1 month intervals. Six subjects were biopsied (two subjects at 1 month, two subjects at 3 months, and two subjects at 6 months). Digital photographic images were taken at 1, 3, and 6 months post-final treatment visits. Images were graded by blinded physicians for fine lines/wrinkles, erythema, dyschromia, and global improvement. Data on discomfort level, satisfaction, and side effects were recorded.
– Overall blinded physician rated global improvement ranged from improved to much improved at 1-, 3-, and 6-month time points. At baseline the average Fitzpatrick wrinkle score was 5.48. At the 6-month follow-up the average score was 3.47. The overall average change in score from pre-treatment to post-treatment was 1.97. Subject self-assessment at 6 months indicated that 90% of subjects were extremely or satisfied with their results. Unanticipated adverse events were absent with anticipated post-treatment erythema lasting for just several hours.
– A novel diffractive lens array used with a picosecond 755 nm alexandrite laser for treatment of wrinkles is highly effective and safe for wrinkles and other signs of photoaging.
Willardson, H., et al. (2017). Diffuse Urticarial Reaction Associated with Titanium Dioxide Following Laser Tattoo Removal Treatments. Photomed Laser Surg. 35(3). 176-180.
– Local and generalized allergic reactions following laser tattoo removal have been documented, but are rare. To our knowledge, this is the fourth documented case of widespread urticarial eruptions following laser tattoo removal treatment. Unlike previously documented cases, this patient’s reaction was found to be associated with titanium dioxide within the tattoo and her symptoms were recalcitrant to medical therapy.
– Ours is the first documented case of a diffuse urticarial reaction following laser tattoo removal treatments that shows a strong association to titanium dioxide within the tattoo pigment. Herein, we describe a novel surgical approach to treat recalcitrant generalized allergic reaction to tattoo pigment.
Winn, A., et al. (2017, March 23). Dermal Piercing Removal: Searching for an Optimal Technique. Dermatol Surg.
– Short article summary of dermal piercings and two different removal techniques in the outpatient setting (punch removal & rock back & forth with hemostats/remove)
Zajdel, N., et al. (2017). Chemical Tattoo Treatment Leading to Systemic Cobalt Hypersensitivity. Skinmed. 15(3). 221-222.
– An otherwise healthy 36-year-old Caucasian woman, without prior history of atopic dermatitis or eczema, presented to an outside dermatologist with a generalized, severely pruritic eruption involving the entire body except the face. One month previously, she had used a 50% trichloroacetic acid tattoo removal solution on a blue-colored tattoo on the medial aspect of the left ankle. The patient’s eruption persisted for 7 months, and after several attempts to slowly taper her prednisone dose, she presented to our institution.
– Biopsy of a truncal lesion revealed spongiotic pustules with a mixed dermal infiltrate and scattered eosinophils, consistent with subacute spongiotic dermatitis.
Zestcott, C., et al. (2017, February 26). What do you think about ink? An examination of implicit and explicit attitudes toward tattooed individuals. J Soc Psychol. 1-16.
– Tattoos are increasing in popularity, yet minimal research has examined implicit attitudes or the relationship between implicit and explicit attitudes toward tattooed individuals. Seventy-seven online participants (Mage = 36.09, 52% women, 78% white, 26% tattooed) completed measures assessing implicit and explicit attitudes toward tattooed individuals. Results revealed evidence of negative implicit attitudes, which were associated with less perceived warmth, competence, and negative explicit evaluations. However, implicit attitudes were not correlated with measures of disgust or social distance. In addition, age predicted implicit prejudice, but other individual difference measures-such as personal tattoo possession, political identity, and internal/external motivations to respond without prejudice-did not. These findings are discussed in terms of how attitudes toward tattooed individuals may be multifaceted, and research may benefit from measuring implicit and explicit attitudes.