CASE STUDY - ALLERGIC CONTACT DERMATITIS IN RELATION TO TATTOOS

Abstract

As tattooing becomes more and more popular, growing numbers of skin reactions caused by tattoos are also becoming frequently encountered by medical professionals. We present a generic case of a tattoo-induced allergic reaction and explore its’ immunological mechanism. This paper also highlights components of tattoo inks, their allergenic potential, and possible options for treatment. There can be different types of allergens in tattoo inks. Some are biodegradable, while others are not. Examples of biodegradable components include natural dyes and preservatives. Allergic reactions caused by such agents may resolve with simple therapy since after a short period they will be cleared from the skin. On the other hand, synthetic molecules and other non-degradable dyes will need invasive therapy, such as surgery, dermatome shaving and most commonly used - laser removal therapy. Most notable in this regard is red ink with the highest incidence. There are no current regulations on tattoo inks, which puts tattoo enthusiasts at a higher risk of developing allergic reactions. There are certain preventive measures, such as patch and dot tests. Because the specificity of these tests is mediocre, despite negative results, an allergic reaction may develop weeks or months later. There are no strict treatment guidelines and each case must be assessed individually. Our patient was a young woman, who developed a local allergic reaction due to the red pigment used in her tattoo. Initial treatment, in this case, was anti-inflammatory to reduce inflammation. The only way to get full resolution in such cases is to remove the allergen (red pigment) from the dermis. The patient was prescribed topical treatment with corticosteroids. Once irritation subsided tattoo removal therapy with Q-switched Nd 532 nm laser was initiated. The inflammation returned after the first session, for which local anti-inflammatory medications were started. Due to the ineffectiveness of laser removal and local treatments systemic therapy with corticosteroids was prescribed with gradually decreasing the dosage and controlling the disease. After two months of this treatment, the patient's condition improved. She is still undergoing therapy with systemic corticosteroids.