Skin Tattoos Research Articles

Tattoo Pigments Are Localized Intracellularly in the Epidermis and Dermis of Fresh and Old Tattoos: In vivo Study Using Two-Photon Excited Fluorescence Lifetime Imaging

Background: The knowledge about the location and kinetics of tattoo pigments in human skin after application and during the recovery is restricted due to the limitation of in vivo methods for visualizing pigments. Here, the localization and distribution of tattoo ink pigments in freshly and old tattooed human skin during the regeneration of the epidermis and dermis were investigated in vivo. Methods: Two-photon excited fluorescence lifetime imaging (TPE-FLIM) was used to identify tattoo ink pigments in human skin in vivo down to the reticular dermis. One subject with a freshly applied tattoo and 10 subjects with tattoos applied over 3 years ago were investigated in the epidermal and dermal layers in vivo. One histological slide of tattooed skin was used to localize skin-resident tattoo pigment using light microscopy. Results: The carbon black particles deposited around the incision have still been visible 84 days after tattoo application, showing delayed recovery of the epidermis. The TPE-FLIM parameters of carbon black tattoo ink pigments were found to be different to all skin components except for melanin. Distinction from melanin in the skin was based on higher fluorescence intensity and agglomerate size. Using TPE-FLIM in vivo tattoo pigment was found in 75% of tattoos applied up to 9 years ago in the epidermis within keratinocytes, dendritic cells, and basal cells and in the dermis within the macrophages, mast cells, and fibroblasts. Loading of highly fluorescent carbon black particles enables in vivo imaging of dendritic cells in the epidermis and fibroblasts in the dermis, which cannot be visualized in native conditions. The collagen I structures showed a higher directionality similar to scar tissue resulting in a greater firmness and decreased elasticity of the tattooed skin. Conclusions: Here, we show the kinetics and location of carbon black tattoo ink pigment immediately after application for the first time in vivo in human skin. Carbon black particles are located exclusively intracellularly in the skin of fresh and old tattoos. They are found within macrophages, mast cells, and fibroblasts in the dermis and within keratinocytes, dendritic cells, and basal cells in the continuously renewed epidermis even in 9-year-old tattoos in skin showing no inflammation.

Comparison of magnetic seed localization to skin tattoo localization for non-palpable breast lesions: preliminary data.

Background: Magnetic seed localization (MSL) is a relatively new method to identify non-palpable breast lesions during surgery. Traditional methods include skin tattoo localization (STL), carbon marking, wire-guided localization, radio-guided occult lesion localization, and many others. We compared Sirius Pintuition system, a novel MSL technology with STL with respect to operative time, intra- and post-operative complications, specimen volume, and re-excision rate.

Accuracy and Efficiency of Patient Setup Using Surface Imaging versus Skin Tattoos for Accelerated Partial Breast Irradiation

Skin tattoos represent the standard approach for surface alignment and setup of breast cancer radiation therapy, yet permanent skin markings contribute to adverse cosmesis and patient dissatisfaction. With the advent of contemporary surface-imaging technology, we evaluated setup accuracy and timing between "tattoo-less" and traditional tattoo-based setup techniques. Patients receiving accelerated partial breast irradiation (APBI) underwent traditional tattoo-based setup (TTB), alternating daily with a tattoo-less setup via surface imaging using AlignRT (ART). Following initial setup, position was verified via daily kV imaging, with matching on surgical clips representing ground truth. Translational shifts (TS) and rotational shifts (RS) were ascertained, as were setup time and total in-room time. Statistical analyses used the Wilcoxon signed rank test and Pitman-Morgan variance test. A total of 43 patients receiving APBI and 356 treatment fractions were analyzed (174 TTB fractions and 182 using ART). For tattoo-less setup via ART, the median absolute TS were 0.31 cm in the vertical (range, 0.08-0.82), 0.23 cm in the lateral (0.05-0.86), and 0.26 cm in the longitudinal (0.02-0.72) axes. For TTB setup, the corresponding median TS were 0.34 cm (0.05-1.98), 0.31 cm (0.09-1.84), and 0.34 cm (0.08-1.25), respectively. The median magnitude shifts were 0.59 (0.30-1.31) for ART and 0.80 (0.27-2.13) for TTB. ART was not statistically distinguishable from TTB in terms of TS, except in the longitudinal direction (P=.154, .059, and .021, respectively), and was superior to TTB for magnitude shift (P < .001). The variance of each TS variable was significantly narrower for ART compared with TTB (P ≤ .001 vertical, P=.001 lateral, P=.005 longitudinal). The median absolute RS for ART was 0.64° rotation (range, 0.00-1.90), 0.65° roll (0.05-2.90), and 0.30° pitch (0.00-1.50). The corresponding median RS for TTB were 0.80° (0.00-2.50), 0.64° (0.00-3.00), and 0.46° (0.00-2.90), respectively. ART setup was not statistically different from TTB in terms of RS (P=.868, .236, and .079, respectively). ART showed lower variance than TTB in terms of pitch (P=.009). The median total in-room time was shorter for ART than TTB (15.42 vs 17.25 minutes; P=.008), as was the median setup time (11.12 vs 13.00 minutes; P=.001). Moreover, ART had a narrower distribution of setup time with fewer lengthy outliers versus TTB. These findings suggest that a tattoo-less setup approach with AlignRT may be sufficiently accurate and expeditious to supplant surface tattoos for patients receiving APBI. Further analyses with larger cohorts will determine whether tattoo-based approaches can be replaced by noninvasive surface imaging.

Tatoo Ink, Magnetism and Sensation of Burn during Magnetic Resonance Imaging, and Introduction of Hand-Held Magnet Testing of Commercial Tattoo Ink Stock Products prior to Use.

Cosmetic tattoos may cause burning sensation during magnetic resonance imaging (MRI) and interrupt the procedure, and thereby any diagnostic workup. Tattoos also may cause disturbing artefacts in MRI images. The sensation, which can be painful, is due to magnetic elements in the tattoo ink deposited in the tattooed skin. It is not a thermal burn but a subjective sensation of burning. Tattoo ink bottles can be tested for magnetic properties by the artist in the studio, before cosmetic tattooing is performed, using a simple magnet test. This test and the pitfalls of the test are described. Hospital departments and clinics should be aware of the problem, and patients assessed prior to MRI regarding their tattoos, particularly eyebrows and eyeliners made in brown and dark colors. Red tattoos exemplified by tattooed lips are not prone to MRI-induced burning sensation. The problem is related to inorganic pigments with ferromagnetic properties.

Tattoo Skin Disease in Cetacea: A Review, with New Cases for the Northeast Pacific.

Tattoo skin disease (TSD) is a poxviral dermatopathy diagnosed in cetaceans. We review the literature on TSD aetiology, clinical characteristics, pathology and epidemiology and evaluate immune responses against the virus. In addition, necropsy reports for fifty-five harbour porpoises (Phocoena phocoena), twenty-two Delphinidae and four Kogiidae stranded in northern California in 2018-2021 were checked for diagnostic tattoo lesions. TSD occurs in the Mediterranean, North and Barents Seas, as well as in the Atlantic, eastern Pacific and Indian Oceans in at least 21 cetacean species, with varying prevalence. Two cetacean poxvirus (CePV) clades are recognised: CePV-1 in odontocetes and CePV-2 in mysticetes. CePV-1 isolates were recovered from six Delphinidae and one Phocoenidae in the Americas, Europe and Hong Kong. Strains from Delphinidae are closely related. Among Phocoenidae, poxviruses were sampled only in harbour porpoises around the British Isles. CePV-2 isolates were obtained from southern right whales (Eubalaena australis) and a bowhead whale (Balaena mysticetus). In healthy animals, an immune response develops over time, with young calves protected by maternal immunity. Salinity and sea surface temperature do not seem to influence TSD prevalence in free-ranging cetaceans. High concentrations of immunotoxic halogenated organochlorines may cause a more severe clinical disease. Substitution and loss of genes involved in anti-viral immunity may favour CePV entry, replication and persistence in the epidermis. Off California, Delphinidae were less often (26.3%) affected by TSD than harbour porpoises (43.6%). Male porpoises were significantly more prone (58.1%) to show clinical disease than females (25%). Among males, TSD affected a high proportion of juveniles and subadults. TSD was not detected in the Kogiidae.

Surface-guided positioning eliminates the need for skin markers in radiotherapy of right sided breast cancer: A single center randomized crossover trial

Background and purposeTo prospectively investigate whether surface guided setup of right sided breast cancer patients can increase efficiency and accuracy compared to traditional skin marker/tattoo based setup. Material and methodsTwenty-five patients were included in this study. Each patient was positioned using skin marks and tattoos (procedure A) for half of the fractions and surface guidance using AlignRT (procedure B) for the other half of the fractions. The order of the two procedures was randomized. Pretreatment CBCT was acquired at every fraction for both setup procedures. A total of ten time points were recorded during every treatment session. Applied couch shifts after CBCT match were recorded and used for potential error calculations if no CBCT had been used. ResultsIn the vertical direction procedure B showed significant smaller population based systematic (Ʃ) and random (σ) errors. However, a significant larger systematic error on the individual patient level (M) was also shown. This was found to be due to patient relaxation between setup and CBCT matching. Procedure B also showed a significant smaller random error in the lateral direction, while no significant differences were seen in the longitudinal direction. No significant difference in setup time was found between the two procedures. ConclusionSetup of right sided breast cancer patients using surface guidance yields higher accuracy than setup using skin marks/tattoos and lasers with the same setup time. Patient alignment for this patient group can safely be done without the use of permanent tattoos and skin marks when utilizing surface-guided patient positioning. However, CBCT should still be used as final setup verification.

Remote and non-invasive quantification of ‘Tattoo Skin Disease-Like’ dermatopathy in endangered Arabian Sea humpback whales using drone photography

Remote and non-invasive quantification of ‘Tattoo Skin Disease-Like’ dermatopathy in endangered Arabian Sea humpback whales using drone photography

Multiple regression analyses to determine the effect of sweating rate and tattoo characteristics on sweat outcome measures during exercise

PurposeTo compare local sweating rate (LSR) and local sweat sodium ([Na+]), chloride ([Cl−]), and potassium ([K+]) concentrations of tattooed skin and contralateral non-tattooed skin during exercise. MethodsThirty-three recreational exercisers (17 men, 16 women) with ≥ 1 unilateral permanent tattoo on the torso/arms were tested during cycling, running, or fitness sessions (26 ± 4 °C and 54 ± 13% relative humidity). Forty-eight tattoos with a range of ink colors, ages (3 weeks to 20 years), and densities (10–100%) were included. Before exercise, the skin was cleaned with alcohol and patches (3 M Tegaderm + Pad) were placed on the tattooed and contralateral non-tattooed skin. LSR was calculated from sweat mass (0.80 ± 0.31 g), patch surface area (11.9 cm2), and duration (62 ± 14 min). Sweat [Na+], [Cl−], and [K+] were measured via ion chromatography.ResultsBased on the analysis of variance results, there were no differences between tattooed and non-tattooed skin for LSR (1.16 ± 0.52 vs. 1.12 ± 0.53 mg/cm2/min; p = 0.51), sweat [Na+] (60.2 ± 23.5 vs. 58.5 ± 22.7 mmol/L; p = 0.27), sweat [Cl−] (52.1 ± 22.4 vs. 50.6 ± 22.0 mmol/L; p = 0.31), or sweat [K+] (5.8 ± 1.6 vs. 5.9 ± 1.4 mmol/L; p = 0.31). Multiple regression analyses suggested that younger tattoos were associated with higher sweat [Na+] (p = 0.045) and colorful tattoos were associated with higher sweat [Cl−] (p = 0.04) compared with contralateral non-tattooed skin. Otherwise, there were no effects of LSR or tattoo characteristics on regression models for LSR or sweat electrolyte concentrations.ConclusionThere were no effects of tattoos on LSR and sweat [K+] during exercise-induced sweating, but tattoo age and color had small effects on sweat [Na+] and sweat [Cl−], respectively.Clinical trial identifiersNCT04240951 was registered on January 27, 2020 and NCT04920266 was registered on June 9, 2021.

Exploratory evaluation of tolerability, performance, and cosmetic acceptance of dexpanthenol-containing dermo-cosmetic wash and sun-care products for tattoo aftercare.

Background and AimsTattoo prevalence has significantly increased over the last decades. Proper tattoo aftercare, such as cleansing, moisturizing, and protection against sunlight, is essential to prevent complications and to keep the beauty of the tattoo. The tolerability, performance, and cosmetic acceptability of two dexpanthenol‐containing dermo‐cosmetic products, a wash and a sun‐care, were investigated on tattooed skin in two separate trials.MethodsTwo single‐center, exploratory, open‐label cosmetic studies were conducted between August and November 2020 to evaluate the dexpanthenol‐containing dermo‐cosmetic products. In the first study, healthy adults applied the 2.5% dexpanthenol‐containing wash right after their tattoo session daily for 14 consecutive days. In the second study, healthy adults applied the 2.5% dexpanthenol‐containing sun‐care sun protection factor 50+ cream on existing tattoos that were daily exposed to sunlight for 28 consecutive days. Clinical examination by a dermatologist and self‐assessment through subject questionnaires were used to assess the tolerability, acceptance, ease of use, and cosmetic outcomes of both products. Additionally, transepidermal water loss and moisturization assessments were performed to evaluate skin hydration after use of the sun‐care product.ResultsBoth study products were well tolerated, and no product related adverse events were reported during the studies. At least 90% of the study participants appreciated the performance of the dexpanthenol‐containing wash and sun‐care product, including moisturizing properties, relief of unpleasant sensations, and preservation of the cosmetic appearance of the tattoo. For the sun‐care, it was shown that its application supported maintaining the skin barrier of tattooed skin, while keeping it hydrated.ConclusionThe 2.5% dexpanthenol‐containing wash and sun‐care products are well tolerated and appreciated by tattooed subjects. Hence, they represent valid options for tattoo aftercare in line with current recommendations and practice.

Tattoos Effect Local Sweat Excretion Rate of Epidermal Growth Factor During Outdoor Group Fitness Exercise

There is interest in the potential of sweat cytokines to serve as non‐invasive biomarkers to monitor immune system function, but many practical questions remain. For example, sweat constituents collected from tattooed (TAT) skin regions may differ from skin regions without permanent tattooing. The purpose of this investigation was to determine if tattooed skin (TAT) differed from contralateral non‐tattooed skin (NT) for sweat cytokines including: EGF, IL‐10, IL‐1α, IL‐1β, IL‐6, IL‐8, TNF‐α, and IL‐31 concentrations and excretion rates during a group fitness exercise session. Moderately trained individuals (males n=8, females n=8, 34±8 y) with at least one permanent tattoo on the upper body (wrist, forearm, tricep, bicep, scapula, shoulder, or torso) participated in a ~60 minute outdoor (~27±3°C, 63±4% RH) group fitness exercise session. Absorbent patches (3M Tegaderm™ + Pad) were used to collect sweat on both TAT and NT skin. Patches were monitored during the exercise session and removed upon moderate saturation. Sweat cytokine concentrations were measured using Multiplex (EMD Millipore, MagPix) customized kits. Local sweat rate (LSR) was calculated from sweat mass over patch surface area (11.9 cm2) and duration of exercise (56±2 min). Excretion rates were calculated as the product of LSR and cytokine concentration. To evaluate differences between TAT and NT skin, paired t‐tests or Wilcoxon signed rank tests were used. Significance level was set at p&lt;0.05. Data are presented as mean±SD for normally and non‐normally distributed data. There were no differences in LSR for TAT vs. NT skin regions (1.20±0.62 vs 1.24±0.53 mg/cm2/min; p=0.70). There were no differences between TAT and NT skin for concentrations of EGF (45±29 vs 53±31 pg/mL; p=0.10), IL‐10 (0.03±0.04 vs 0.07±0.13 pg/mL; p=0.21), IL‐1β (1.66±1.12 vs 1.86±1.07 pg/mL; p=0.55), IL‐8 (0.60±0.50 vs 0.56±0.64 pg/mL; p=0.27), IL‐1α (618±550 vs 807±913 pg/mL; p=0.3) or TNF‐α (0.40±0.05 vs 0.40±0.04 pg/mL; p=0.85). There was below minimum or no level of detection for TAT and NT skin for IL‐6 and IL‐31. Excretion rates were significantly different between TAT and NT skin for EGF (0.05±0.04 vs 0.06±0.03 pg/cm2/min; p=0.04). In summary, EGF excretion rate was lower in TAT skin than NT skin during exercise, but TAT did not affect the concentrations or excretion rates of any other cytokines measured.

No Effect of Permanent Tattoos on Local Sweat Concentration or Excretion Rate of Urea Nitrogen, Cortisol, Glucose, or Lactate During Exercise

Permanent tattooing is common on areas of the skin typically sampled for sweat diagnostics, yet its potential to alter local sweat concentration and excretion rate (ER) of metabolites and other compounds is unknown. The purpose of this study was to investigate the influence of tattooed skin (TAT) on local sweat concentration and ER of urea nitrogen (UN), cortisol (CORT), glucose (GLU) and lactate (LAC) when compared to contralateral non‐tattooed skin (NT) during a group fitness exercise session. Moderately trained participants (males n=8, females n=8, 34±8 y) with at least one permanent tattoo (age of tattoo 7±5 y) on the upper body (arm, scapula, or thorax regions) underwent a ~60 minute outdoor (~27±3°C, 63±4% RH, 26±3°C WBGT) group fitness exercise session. Sweat was collected with absorbent patches (3MTMTegaderm+PAD) placed on the TAT and on NT. Patches were monitored during exercise and removed upon moderate saturation. Local sweat rate (LSR) was calculated from sweat mass over patch surface area (11.9 cm2) and exercise duration (56±2 min). Excretion rates (ER) were calculated as the product of analyte concentration and local SR. Sweat was analyzed by ELISA for UN (Invitrogen, ThermoFisher Scientific), CORT (Invitrogen, ThermoFisher Scientific), GLU (Caymen Chemical Co.) and LAC (LSBio). To evaluate differences between TAT and NT skin, paired t‐tests or Wilcoxon signed rank tests were used. Significance level was set at p&lt;0.05. Data are presented as mean±SD or median±IQR for normally and non‐normally distributed data respectively. There were no differences in LSR for TAT vs. NT conditions (1.1±0.7 vs 1.2±0.6 mg/cm2/min; p=0.93). TAT and NT skin had similar concentrations for UN (19.2±6.0 vs 20.7±6.1 mg/dL; p=0.28), CORT (2.4±1.3 vs 2.5±1.4 ng/mL; p=0.41), GLU (0.22±0.3 vs 0.24±0.2 mg/dL; p=0.31), and LAC (5.8±6.3 vs 5.9±6.6 mM; p=0.83). ERs were also similar for all analytes: UN (252±150 vs 270±136 ng/cm2/min; p=0.34), CORT (1.8±3.4 vs 2.1±3.4 pg/cm2/min; p=0.46), GLU (2.3±1.6 vs 2.3±2.4 ng/cm2/min; p=0.40) and LAC (6.4±10.9 vs 7.1±10.1 ng/cm2/min; p&gt;0.999). In conclusion, TAT does not appear to affect the LSR, concentration, or ER of select analytes during ~60 min of fitness exercise.

Co-localized line-field confocal optical coherence tomography and confocal Raman microspectroscopy for three-dimensional high-resolution morphological and molecular characterization of skin tissues ex vivo.

Line-field confocal optical coherence tomography (LC-OCT) is an optical modality that provides three-dimensional (3D) images of the skin at cellular resolution. Confocal Raman microspectroscopy (CRM) is a label-free optical technique that can provide point measurement of the molecular content of the skin. This work presents a method to co-localize LC-OCT and CRM acquisitions for morpho-molecular analysis of ex vivo skin tissues at cellular level. The co-localization method allows acquisition of Raman spectra at specific locations in a sample identified from a 3D LC-OCT image, with an accuracy of ± 20 µm. The method was applied to the characterization of tattooed skin biopsies with adverse tattoo reactions. LC-OCT images allowed to target specific regions in the biopsies where the presence of tattoo ink was revealed by detection of the Raman signature of ink pigments. Micrometer-sized foreign bodies of various materials as well as inflammatory cells were also identified within the biopsies. From these results, we demonstrate the value of the LC-OCT-CRM co-localization method and its potential for future ex vivo analysis of suspicious skin lesions.

Diffused reflectance measurements to detect tattoo ink location in skin using the crossover point.

Tattoos are highly trendy in western culture, but many people regret their tattoos for many reasons. It is essential to be aware of the ink location in advance to reduce the long and short-term side effects. In this study, diffuse reflectance (DR) experiments were conducted on two-layer (2L) tissue-mimicking phantoms, where ink was sandwiched between the layers. An appreciable difference in the DR profile was found between the 2L phantom with and without the tattoo ink using the crossover point (Cp) method. Our technique was applied to ex vivo porcine skin. A point of intersection was found, between the skin and the tattooed skin. In the shorter wavelengths (500-600 nm), a distinguishable 2L behavior was found, and in longer wavelengths (600-850 nm), a single layer behavior was found between the tattooed skin before and after the intersection. In biological tissue, this Cp indeed finds the tattoo ink without harm to the surrounding skin.

Keratoacanthoma occurring in a recent skin tattoo and self-involuted after a punch biopsy.

article: Keratoacanthoma occurring in a recent skin tattoo and self-involuted after a punch biopsy - Italian Journal of Dermatology and Venereology 2021 December;156(Suppl. 1 to No. 6):75-6 - Minerva Medica - Journals

Burn depth assessment in tattooed patients

Tattoos are commonly accepted as a lifestyle choice, with an estimated 10-20% of the global population having a tattoo. Burn injuries in tattooed skin can be challenging to assess, and incorrect management can lead to an unnecessary burden on resources. This may lead to preventable patient morbidity. We present a case series of patients presenting to our unit with burn injuries on tattooed skin, and discuss recommendations for assessing and optimising care in this cohort. Four male patients aged 23 to 50 years old are discussed in this study, with burn injuries to limb tattooed skin. One patient underwent surgical management and upon a test shave of the apparent full thickness burn with tattoo pigmentation, showed a bleeding dermis which would indicate a more superficial burn. A second patient had burn depth masked a colour tattoo that mimicked a mid to deep dermal burn. We highlight the difficulties in assessing patients with burn injuries in tattooed skin and the importance of ensuring the correct diagnosis in depth of burn. This is to allow optimal treatment and avoid potential complications that may occur as a result of misdiagnosis.

Cutaneous Malignancies in Tattoos, a Case Series of Six Patients.

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.

The Role of Oxygen in the Skin-Sparing Effect of Flash Proton Irradiation

Ultra-high dose rate irradiation (Flash irradiation) has been proved to be able to spare normal tissues. Radiation-induced oxygen depletion might contribute to the effect. In the present study, we try to verify the protective effect of Flash proton irradiation on the skin and highlight the association of oxygen with it.A Flash proton experimental platform utilizing a 228.9 MeV proton beam was established to generate a homogenous field of 1.2Í1.6 cm2. Physical dosimetry and biological experiments with normal air condition cultured cells were conducted to affirm the dose. Two biologically independent experiments were conducted at the doses of 25 Gy and 27 Gy respectively. The skin tattoos were made by intracutaneously injected Indian ink to help to detect the contraction fraction. The mice of the Flash+O2 cohort were kept inside a designed chamber from 6 minutes before irradiation to the end of the exposure. Tying the legs of the hypoxic cohorts for 3 minutes helped to generate an anoxic skin condition. The epidermis thickness of the 25 Gy irradiated mice was measured with the hematoxylin-eosin-stained slides.Compared with the 27 Gy conventional dose rate (CDR) irradiated group, the same dose of Flash proton irradiation led to less skin contraction. The contraction fraction of the Flash irradiated oxygen-breathing group was similar to that of the normal CDR group but was significantly different from the Flash group. No difference was detected between the hypoxic 27 Gy Flash and CDR cohorts. The skin contraction fractions of each cohort at 72 days after irradiation were showed in Table 1. An essentially identical Flash effect was obtained at 25 Gy (P = 0.0073, Flash vs CDR). The epidermis thickness of the Flash group was comparable to the control group, whereas the CDR irradiation caused epidermal incrassation.Flash proton irradiation decreased the skin contraction and epidermis thickness of mice. This effect is related to oxygen depletion during the irradiation procedure. Table 1. Skin contraction fractions at 72 days after irradiation (x̄ ± SD).

Does Tumor Marking Before Neoadjuvant Chemotherapy Helps Achieve Better Outcomes in Patients Undergoing Breast Conservative Surgery? A Systematic Review.

Patients with breast cancer are increasingly being offered breast conserving surgery (BCS) following neoadjuvant chemotherapy (NACT). We aimed to conduct a systematic review to assess the advantage of tumor marking in patients undergoing BCS after NACT. After registering the protocol for a systematic review with PROSPERO, a systematic search was conducted through September 30, 2020, for all studies involving patients undergoing BCS post NACT after tumor marking. Margin status on final histology was the primary outcome. Oxford Centre for Evidence Based Medicine (OCEBM) levels were used to assess internal validity. A total of 636 records from Medline/PubMed, 1381 from Embase, and 1422 from Cochrane library were extracted. After screening, 15 articles (1520 patients) were included for data synthesis. For marking, 6 studies used metallic markers and 5 used 125I-radioactive seeds (RSL) followed by skin tattoo and radio-guided occult lesion localization using 99mTc (ROLL) in one study each. Most studies used a single marker at the center except for two (143 patients), who practiced the bracketing technique. Incidence of unsatisfactory margins (positive/close) ranged from 5 to 23.5%. After excluding patients with complete pathological response, the "adjusted unsatisfactory margin" rate was found to be 19.3% (10.4-33%). Overall 20.6 recurrences (locoregional/distant) were reported per 1000 patient-years follow-up. Overall survival (OS) was only reported by one study as 96.6% and 84.7% in patients with and without marker placement (p = .01). Re-excision and secondary mastectomy rates (reported by nine studies) were 7.3% and 5.7% respectively. There is limited evidence that tumor marking before neoadjuvant chemotherapy improves the rate of unsatisfactory margins or survival outcomes in a patient undergoing BCS after NACT.

Self‐Powered and Imperceptible Electronic Tattoos Based on Silk Protein Nanofiber and Carbon Nanotubes for Human–Machine Interfaces

AbstractTriboelectric electronic skins (E‐skins) can be used as primary interactive devices for human–machine interfaces (HMIs). However, devices for seamless on‐skin operations must be soft and deformable, and attachable to and compatible with the skin. In this paper, a substrate‐free, skin‐compatible, skin‐attachable, mechanically deformable, and self‐powered E‐tattoo sticker consisting of carbon nanotubes (CNTs) and silk nanofibers (SNFs) is presented. The E‐tattoo can be imperceptibly tattooed on the skin and removed with water. When the device touches naked skin, triboelectric signals are generated. Because of the micro‐to‐nano hierarchical pores (with high surface‐to‐volume ratios), contact‐induced electrification generates a power density of ≈6 mW m−2 and pressure sensitivity of ≈0.069 kPa−1. The power generated on the tattooed skin can activate small electronic devices. Moreover, whole‐body joint movements can be monitored and tactile movements can be mapped by reading the generated electrical signals. The presented E‐tattoo system can promote the development of flexible energy and sensor systems for self‐powered, energy‐autonomous, imperceptible E‐skin devices for HMIs and artificial intelligent robotics and prostheses.

Silk E‐Tattoos: Multifunctional and Ultrathin Electronic Tattoo for On‐Skin Diagnostic and Therapeutic Applications (Adv. Mater. 24/2021)

A multifunctional electronic skin tattoo system is developed by drawing carbon nanotube patterns on electrospun silk nanofiber mats, as described by Sunghwan Kim and co-workers in article number 2008308. The tattoo system offers ultrathin, ultralight, biocompatible, deformable, and skin adhesion. Heat-stimulated drug delivery with controlled temperature and electrophysiological signal monitoring are possible using this electronic tattoo system in a noninvasive manner.