Introduction
Methods
Types of Red Tattoo Pigment (Organic Versus Inorganic)
Patterns of Red Tattoo Pigment Reactions
Dermatitis
Lichenoid
Pseudolymphomatous
Granulomatous
Miscellaneous Reaction Patterns
Skin reaction | Histology |
---|---|
Allergic contact dermatitis | Acanthosis, spongiosis, perivascular lymphocytic inflammatory infiltrate |
Lichenoid dermatoses | Acanthosis and thickening of the stratum corneum |
Granulomatous | Giant cell positive or negative |
Pseudolmphomatous | T- or B-cell lymphoma equivalent |
Pseudoepitheliomatous hyperplasia | Reactive changes: similar to SCC and keratoacanthoma |
Irregular acanthosis | |
Low mitotic activity |
Treatment of Red Pigment Reactions
Conventional Methods of Tattoo Removal
Results of the Literature Search
Study | Red tattoo reaction | Aim | No. of patients, N
| Findings |
---|---|---|---|---|
Kyanko et al. [45] | Dermatitis | Case study | 2 | CO2 laser successfully treated erythema and pruritus in red tattoo dermatitis |
England et al. [54] | Dermatitis | Case study | 1 | Nd:YAG laser-induced allergic reaction in tattoo removal |
Jager and Jappe [55] | Dermatitis | Case study on nickel allergy | 1 | Red tattoo dermatitis responds to topical steroids |
Hogsberg et al. [15] | Dermatitis | Review of histological pattern of skin biopsies in red tattoo reactions | 19 | 78% of biopsies demonstrated dermatitis with T lymphocytes and Langerhans cell infiltration |
Cruz et al. [7] | Granulomatous | Case study | 4 | Only 1 in 4 of red pigment granulomatous lesions contained mercury |
Sweeney et al. [31] | Granulomatous | Case study | 1 | Granuloma annulare post red tattoo |
Godinho et al. [32] | Granulomatous | Case study | 1 | Successful treatment with 6-month course of allopurinol |
Bouchy et al. [29] | Pseudolymphoma | Case study showing 2-month delayed reaction | 1 | 35-year-old male developed a 2-month delayed pseudolymphoma in red areas of tattoo |
Jaehn et al. [30] | Pseudolymphoma | Case study | 1 | 6-month delayed pseudolymphoma in tattoo, successfully treated with split thickness skin graft |
Litvinov and Sasseville [33] | Pyoderma gangrenosum | Case study | 1 | Triggered by red tattoo dye |
Taaffe et al. [22] | Lichenoid | Case study of laser treatment | 1 | Successful treatment with 8 sessions of Q-switched ND:YAG laser |
Biro and Klein [43] | Lichenoid | Case study of steroid treatment | 1 | Cinnabar tattoo developed eczematous reaction 9 years post tattoo. Treated successfully with excision and 3-month low-dose topical steroids |
Dang et al. [42] | Lichenoid | Case study of steroid treatment | 1 | Successful halobetasol ointment treatment for lichenoid in red pigment areas of tattoo |
Antony and Harland [21] | Lichenoid | Open non-randomised clinical trial of laser treatment | 7 | Lichenoid red tattoo responds to Q-switched 532 nm Nd:YAG laser after 6 sessions |
De Argila et al. [44] | Lichenoid | Case study of laser treatment | 1 | Successful treatment of lichenoid red tattoo with 5 sessions of Er:YAG laser |
Anderson et al. [55] | Pigment darkening | Case study | 5 | 5 cases of irreversible ink darkening with Q-switched and pulsed laser treatment |
Herbich [56] | Red tattoo | Case study | 1 | Successful removal of facial iron oxide tattoo with CO2 laser |
Serup and Hutton Carlsen [20] | Red tattoo reactions in general | Report of results of patch testing in red tattoo reactions | 90 | Red tattoo reactions do not predispose patients to have a positive patch test with common allergens |