Abstract
Background: A variety of side effects following the tattooing of the skin were reported over the years. Analytical studies showed that some tattoo inks contain harmful compounds. Methods: We presented six patient cases with cutaneous malignancies in tattooed skin and performed an extensive literature research. Results: Two patients with black ink tattoos that were diagnosed with malignant melanoma raises the number of described cases to 36 patients. One of the patients developed an immunologic reaction limited to the tattoo area after treatment with a targeted immune therapy. In the other patient, the malignancy (malignant melanoma) was fatal. Basal cell carcinoma was seen in four patients with tattoos containing varying ink colors (black, green, red). This increased the number of described patient cases to 18. Although some ink components and their cleavage products have carcinogenic properties, epidemiological evidence for a causative correlation fails. Further epidemiologic studies on tattoos and malignancies, as well as on the appearance of naevi in tattoos, are necessary. Determining the type of mutation might be helpful to separate sun-induced tumors from skin cancers due to other pathogenic mechanisms.
Highlights
Tattooing is defined as the artificial introduction of exogenous pigments into the dermis [1]
The superficially spreading malignant melanoma (SSMM) was re-excised with 1 cm margins and, because of the size of the melanoma in combination with histopathological signs of regression, we decided to perform a sentinel lymph-node excision
There was a positive sentinel lymph node in the right groin containing micro metastasis up to 1.2 mm, so the patient was diagnosed with stage IIIA (AJCC 2017) malignant melanoma
Summary
Tattooing is defined as the artificial introduction of exogenous pigments into the dermis [1]. Several adverse events are reported on tattooed skin [7,8]. These include type IV allergic reactions (allergic contact dermatitis), and skin cancer [7,9,10]. Results: Two patients with black ink tattoos that were diagnosed with malignant melanoma raises the number of described cases to 36 patients. Basal cell carcinoma was seen in four patients with tattoos containing varying ink colors (black, green, red). This increased the number of described patient cases to 18. Determining the type of mutation might be helpful to separate sun-induced tumors from skin cancers due to other pathogenic mechanisms
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