An Invisible Dermal Nanotattoo-Based Smart Wearable Sensor for eDiagnostics of Jaundice.

Despite substantial progress in the diagnosis of jaundice/hyperbilirubinemia as the most common disease and cause of hospitalization of newborns, on the eve of Industry/Healthcare 5.0, the development of accurate and reliable wearable diagnostic sensors for noninvasive smart monitoring of bilirubin (BIL) is still in high demand. Aiming to fabricate a smart wearable sensor for early diagnosis of neonatal jaundice and its therapeutic monitoring, we here report a fluorescent dermal nanotattoo that further coupled with an IoT-integrated wearable optoelectronic reader for minimally invasive, continuous, and real-time monitoring of BIL in interstitial fluid. Selective recovery of quenched fluorescence of the dermal tattoo sensor, composed of biocompatible dissolving/hydrogel microneedles loaded with fluorescent carbon quantum dots, upon blue light exposure used for jaundice phototherapy was utilized for highly selective BIL sensing. The fascinating features of our developed smart wearable tattoo sensor and its successful results with high correlation with blood BIL results make it a highly promising sensor for easy, minimally invasive, reliable, and smart eDiagnostics and continuous therapeutic eMonitoring of jaundice and other BIL-induced diseases at the point of care. We envision that the developed nanotattoo sensing bioplatform will inspire the development of future smart tattoo sensors in various diagnostic and monitoring scenarios.

Allergic Contact Dermatitis Reaction to Permanent Tattoo Containing Paraphenylenediamine: A Case Report.

Paraphenylenediamine (PPD) is a well-known culprit allergen in the literature and clinical practice. Although this has been described in temporary tattoos, the definite implication of PPD in permanent tattoos has not been described. We report a patient who developed severe allergic contact dermatitis (ACD) requiring skin grafting after receiving a permanent tattoo with ink containing PPD. A 30-year-old female with a past history of atopic dermatitis and psoriasis presented with a 2-week history of cutaneous reaction to a recent tattoo. The patient noticed inflammation and irritation of the tattoo site the day after administration. The patient was previously identified on patch testing to have a PPD allergy after evaluation for dermatitis after hair dye application. Following the tattoo placement, she applied soap and bacitracin cream which she had used several years prior on a similar tattoo. On presentation 2 weeks later, she was found to have a deep ulcerated plaque with an indurated border encompassing the area of the tattoo. She was referred to the emergency department and admitted for treatment, ultimately requiring debridement and skin grafting. The patient obtained the safety data sheets for the tattoo inks which revealed PPD as an ingredient in every color. We believe this is the first confirmed case of PPD being implicated as the causative agent for ACD to a permanent tattoo. Tattoo ink is unregulated, and formulas are proprietary which makes safe practice difficult for patients with sensitivities. We advocate for consistent ingredient labeling, regulation, and transparency within the tattoo ink industry.

Insights into hair dye use and self-reported adverse skin reactions in the Dutch general population: A cross-sectional questionnaire-based study.

BACKGROUND: Hair dyes are widely used in daily life. However, data on self-reported adverse skin reactions are scarce. OBJECTIVES: To estimate the proportion of lifetime hair dye use and self-reported adverse skin reactions in the Dutch general population, and to investigate the association between (adverse skin reactions to) hair dye use and contact allergy-related factors. METHODS: This cross-sectional study collected questionnaire-derived data from the Lifelines cohort. Logistic regression analyses were conducted between (adverse skin reactions to) hair dye use and black henna tattoo use, reactions to henna tattoos, patch testing, hand eczema and an occupation as hairdresser or beautician. RESULTS: The proportion of hair dye use was 63.1% of 70 987 participants, of which 6.8% experienced adverse skin reactions, mostly mild (77.7%). Hair dye users and those with skin reactions were both positively associated (p < 0.05) with female sex, middle-age, (positive) patch test results and hairdresser or beautician occupations. Hair dye users were more likely to have had henna tattoos, and those with reactions to hair dye were more likely to have had reactions to henna tattoos. CONCLUSIONS: Hair dye use is prevalent among the Dutch general population and frequently causes adverse skin reactions, especially in females who had black henna tattoos.

"Art is just something that makes people heal"-a qualitative investigation of tattoo artists' perspectives on cancer survivorship therapeutic tattoos.

PURPOSE: Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists' (TAs') perspectives on the types, impacts, barriers, and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves. METHODS: Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analyzed thematically. RESULTS: The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos. CONCLUSION: This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs' perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, and a reduction in barriers to the practice and greater collaboration between HPs and TAs. IMPLICATIONS FOR CANCER SURVIVORS: Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.

Winston Churchill's Mother and the Inked Operator: Health Risks and Biokinetics of Tattoo Inks.

Tattooing is an ancient art form widely practiced among Special Operations Forces (SOF) personnel. The ink injected into skin tissue during tattooing often contains various compounds, including impurities and contaminants, which can pose health risks. This article provides an overview of recent research to inform SOF medical personnel about the potential health implications of both new and older tattoos.

Advancing patient setup: A comprehensive scoping review of tattoo-less techniques in radiation therapy.

In recent years, alternative methods to dark ink tattoos for patient positioning in radiotherapy have been explored. This review aims to analyse the evidence for alternative strategies to traditional dark tattoos. An electronic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Sciences and SCOPUS. Twenty-one articles out of 383 titles fulfilled the selection criteria and were included in the review. These studies were categorized into tattoo-less methods (n=14), UV ink tattoos (n=4) and other techniques (n=3). In most of the selected articles (n=13) focusing on tattoo-less treatments, SGRT is used for patient positioning. These three alternative techniques to dark tattoos are used in different anatomical regions and treatment modalities, with breast cancer being the most prevalent. Tattoo-less techniques are a promising alternative to traditional tattoo-based methods for patient positioning. They have the potential to improve the patient experience and represent an area of ongoing innovation and improvement.

Breathable, Adhesive, and Biomimetic Skin-Like Super Tattoo.

Electronic tattoo, capable of imperceivably acquiring bio-electrical signals from the body, is broadly applied in healthcare and human-machine interface. Tattoo substrate, the foundation of electronic tattoo, is expected to be mechanically mimetic to skin, adhesive, and breathable, and yet remains highly challenging to achieve. Herein, the study mimics human skin and design a breathable, adhesive, and mechanically skin-like super tattoo substrate based on an ultra-thin film (≈2 µm). Similar to skin, super tattoo demonstrates strain-adaptive stiffening properties with high tear energy (5.4 kJ·m-2) and toughness (1.3 MJ·m-3). Superior to skin, it exhibits high adhesion, ionic conductivity, and permeability. A variety of conductive electrodes can be processed on it, showing the universality toward an ideal platform for electronic tattoo with stable and low contact impedance. Super tattoo-based electrodes can imperceivably and accurately monitor weak electromyography (EMG) of swallowing on the junction, providing effective guidance for rehabilitation training of dysphagia.

Fading and Color Reproducibility of Nipple-Areola Tattoos in Asian Patients.

Background The purpose of this study was to clarify fading, red, green, and blue values (RGB) change, and color reproducibility for nipple-areola complex (NAC) tattoos. Methods NAC tattooing was performed on 60 sites in 59 Japanese patients prospectively. The evaluation was assessed using digital photo, Casmatch standardization, and RGB and luminance values preoperatively, immediately after, 1 week, 1, 3, 6, and 12 months after tattooing. RGB and luminance values changes over time, time-adjusted fading rate, and the rate of luminance at 12 months were calculated. In color reproducibility study ( n = 34), RGB values after 12 months were compared with the color sample about dark/reddish and light/less reddish pigments. Results RGB varied widely from immediately after to 1 month after tattooing. For RGB and luminance, significant differences were seen between pre and immediate after, 1 and 3 months, 3 and 6 months, and 6 and 12 months. In G values, significant differences were seen between all neighboring points. The fading rate tended to decrease as time progresses, but was not significant, that is, fading continued even between 6 and 12 months. Luminance was 9% brighter than contralateral NAC at 12 months. Color reproducibility tended to be higher with dark/reddish pigments, despite no significant differences. Conclusion The fading rate of tattooed NACs tended to decrease as time progresses, but fading still occurs between 6 and 12 months. Luminance was 9% brighter than contralateral NAC at 12 months after.

Epidemiology of patch tested patients with permanent tattoos-A comparative analysis of 9693 IVDK patients (2020-2022).

BACKGROUND: Permanent tattooing is the invasive introduction of tattoo ink (pigments) into the dermis. The ink and aftercare cosmetics applied on pre-damaged skin may contain skin sensitisers. OBJECTIVES: To identify patient characteristics and the pattern of sensitisation in tattooed patients patch tested within the Information Network of Departments of Dermatology (IVDK). PATIENTS AND METHODS: Comparative analysis of patient characteristics and reaction frequencies to baseline series allergens in 1648 consecutive patients with and 8045 consecutive patients without permanent tattoos. Non-overlapping 95%-confidence intervals were considered as significant. RESULTS: Having permanent tattoos was related with female sex, age <40 years, tobacco smoking, atopic dermatitis, (occupational) hand dermatitis and being employed in particular occupational groups (e.g., healthcare workers, mechanics, hairdressers). Sensitisation to nickel was increased in tattooed patients and associated with female sex (OR 4.23 [95%-CI, 3.48-5.18]), age ≥40 years (OR 1.26 [95%-CI, 1.08-1.49]), tobacco smoking (OR 1.19 [95%-CI, 1.01-1.40]) and having permanent tattoos (OR 1.27 [95%-CI, 1.05-1.53]). CONCLUSIONS: The association between nickel sensitisation and permanent tattoos is probably confounded by past reactions to pierced costume jewellery. Socio-economic factors most probably contribute to the connection between tattoos, tobacco smoking, occupational or hand dermatitis, and being employed in particular occupational groups.

Ultrathin silk nanofiber-carbon nanotube skin tattoos for wirelessly triggered and temperature feedbacked transdermal drug delivery.

Transdermal drug delivery has emerged as an alternative to conventional drug delivery systems as it enables painless and convenient drug administration. However, next-generation healthcare systems need to facilitate "on-demand" delivery operations and should be highly efficient to penetrate the physiological barriers in the skin. Here, we report an ultrathin dye-loaded epidermal tattoo (UDET) that allows wirelessly stimulated drug delivery with high efficiency. The UDET consists of an electrospun dye-loaded silk nanofiber mat and a covered carbon nanotube (CNT) layer. UDETs are conformally tattooed on pigskins and show stable operation under mechanical deformation. Biological fluorescence dyes such as vitamin B12, riboflavin, rhodamine B, and sodium fluorescein are applied as model drugs. Illuminating the UDET by a low-power light-emitting diode (< 34.5 mW/cm2) triggers transdermal drug delivery due to heat generation. The CNTs convert the absorbed light into heat, and then the dyes loaded on silk can be diffused through the epidermis. The CNT layer is electrically conductive and can detect the temperature by reading the resistance change (0.1917 Ω/°C). This indicates that the UDET can be used simultaneously to read temperature and deliver the loaded dye molecules, making it a promising on-demand drug delivery strategy for future medicine technology. Supplementary Information: The online version contains supplementary material available at 10.1007/s13534-024-00363-6.

Melanin-Based Nanoparticles for Lymph Node Tattooing: Experimental, Histopathological and Ultrastructural Study.

In breast cancer, Targeted Axillary Dissection (TAD) allows for the selective excision of the sentinel lymph node (SLN) during primary tumor surgery. TAD consists of the resection of labelled SLNs prior to neoadjuvant chemotherapy (NACT). Numerous clinical and preclinical studies have explored the use of carbon-based colloids for SLN tattooing prior to NACT. However, carbon vectors show varying degrees of inflammatory reactions and, in about one fifth of cases, carbon particles migrate via the lymphatic pathway to other nodes, causing the SLN to mismatch the tattooed node. To overcome these limitations, in this study, we explored the use of melanin as a staining endogenous pigment. We synthesized and characterized melanin-loaded polymeric nanoparticles (Mel-NPs) and used them to tattoo lymph nodes in pig animal models given the similarity in the size of the human and pig nodes. Mel-NPs tattooed lymph nodes showed high identification rates, reaching 83.3% positive identification 16 weeks after tattooing. We did not observe any reduction in the identification as time increased, implying that the colloid is stable in the lymph node tissue. In addition, we performed histological and ultrastructural studies to characterize the biological behavior of the tag. We observed foreign-body-like granulomatous inflammatory responses associated with Mel-NPs, characterized by the formation of multinucleated giant cells. In addition, electron microscopy studies showed that uptake is mainly performed by macrophages, and that macrophages undergo cellular damage associated with particle uptake.

Art on the skin, lifesaving within: Exploring the role of tattoo artists in suicide prevention.

Different populations experience suicide at different rates. Some studies have found an increased risk of suicide among individuals with tattoos. Studies indicate a higher prevalence of mental health disorders among individuals with one or more tattoos. These findings signal a need to explore suicide prevention in tattoo shops. The aim of this project is to determine the feasibility, acceptability, and interest of providing education on suicide prevention among tattoo artists. We conducted a cross-sectional survey with tattoo artists. Survey items assessed artists' experiences with clients expressing mental health issues or suicidal thoughts, their comfort level assisting clients, and general perceptions around suicide and stigma. Seventy-nine surveys were collected. Most artists reported that they have had at least one situation in which a client mentioned something that made them concerned about that client's mental health. Most respondents reported that a client has expressed suicidal thoughts to them at least once. Our study demonstrated that tattoo artists encounter clients who express mental health challenges as well as suicidal ideation, underscoring the potential role for tattoo artists in supporting individuals at risk for suicidal thoughts and behaviors.

Assessing the readability and quality of online patient information for laser tattooremoval.

Just as tattoos continue to increase in popularity, many people with tattoos also seek removal, often due to career concerns. Prospective clients interested in laser tattoo removal may do research about the procedure online, as the internet increasingly becomes a resource to get preliminary health information. However, it is important that the online health information on the topic be of high quality and be accessible to all patients. We analyzed 77 websites from a Google search query using the terms "Laser tattoo removal patient Information" and "Laser tattoo removal patient Instructions" to assess this. The websites were evaluated for their readability using multiple validated indices and comprehensiveness. We found that websites had a broad readability range, from elementary to college, though most were above the recommended eighth-grade reading level. Less than half of the websites adequately discussed the increased risk of pigmentary complications in the skin of color clients or emphasized the importance of consulting with a board-certified dermatologist/plastic surgeon before the procedure. Over 90% of the websites noted that multiple laser treatments are likely needed for complete clearance of tattoos. The findings from our study underscore a significant gap in the accessibility and quality of online information for patients considering laser tattoo removal, particularly in addressing specific risks for patients with darker skin tones and emphasizing the need for consulting a board-certified physician before undergoing the procedure. It is important that online resources for laser tattoo removal be appropriately written to allow better decision-making, expectations, and future satisfaction for potential clients interested in the procedure.

A Human-Computer Interaction Strategy for An FPGA Platform Boosted Integrated "Perception-Memory" System Based on Electronic Tattoos and Memristors.

The integrated "perception-memory" system is receiving increasing attention due to its crucial applications in humanoid robots, as well as in the simulation of the human retina and brain. Here, a Field Programmable Gate Array (FPGA) platform-boosted system that enables the sensing, recognition, and memory for human-computer interaction is reported by the combination of ultra-thin Ag/Al/Paster-based electronic tattoos (AAP) and Tantalum Oxide/Indium Gallium Zinc Oxide (Ta2O5/IGZO)-based memristors. Notably, the AAP demonstrates exceptional capabilities in accommodating the strain caused by skin deformation, thanks to its unique structural design, which ensures a secure fit to the skin and enables the prolonged monitoring of physiological signals. By utilizing Ta2O5/IGZO as the functional layer, a high switching ratio is conferred to the memristor, and an integrated system for sensing, distinguishing, storing, and controlling the machine hand of multiple human physiological signals is constructed together with the AAP. Further, the proposed system implements emergency calls and smart homes using facial electromyogram signals and utilizing logical entailment to realize the control of the music interface. This innovative "perception-memory" integrated system not only serves the disabled, enhancing human-computer interaction but also provides an alternative avenue to enhance the quality of life and autonomy of individuals with disabilities.

A novel polymer platform for endoscopic tattooing with high efficacy and safety.

Endoscopic tattooing plays a pivotal role in modern endoscopic localization of gastrointestinal lesions, facilitating further surgical intervention and aiding in the postoperative identification and repositioning of lesions. However, traditional endoscopic tattoo dyes often suffer from drawbacks such as side effects, short tattoo duration, and high overall costs. In this study, we developed polyvinylpyrrolidone (PVP)-modified polypyrrole (PPy) nanoparticles by oxidizing pyrrole in a PVP aqueous solution to create a PPy/PVP nanoparticle solution. This innovation aims to enhance endoscopic tattooing efficiency and mitigate the limitations associated with current tattooing methods. Both in vitro and in vivo evaluations confirmed the biosafety of PPy/PVP nanoparticles. Endoscopic tattooing experiments conducted in a pig model demonstrated the dye's stability within the digestive tract. Similarly, subcutaneous tissue tattooing experiments performed in a mouse model revealed the sustained stability of the PPy/PVP tattoo dye for at least 180 days. With its robust stability, safety, and longevity, PPy/PVP nanoparticles hold promise as novel tattoo dyes for marking intestinal lesion sites. This advancement has the potential to enhance the accuracy of lesion localization and long-term tracking.

Laser tattoo removal strategies: Part II: A review of the methods, techniques, and complications involved in tattoo removal.

The rising global popularity of cosmetic and corrective tattoos has concurrently led to an increased demand for their removal. While in the past, methods like surgical excision, chemical destruction, and dermabrasion were employed, lasers have emerged as a reliable and effective tool for tattoo removal. Increasing technological options and combination treatment strategies have raised the importance of understanding the various approaches to laser tattoo removal along with their respective clinical impact. This CME aims to describe the multifaceted aspects of laser tattoo removal, including the method selection, application principles, and safety considerations. Furthermore, it addresses the factors considered when selecting the most suitable laser to achieve optimal treatment outcomes.

Detection of anaerobic and aerobic bacteria from commercial tattoo and permanent makeup inks.

Tattooing and use of permanent makeup (PMU) have dramatically increased over the last decade, with a concomitant increase in ink-related infections. Studies have shown evidence that commercial tattoo and PMU inks are frequently contaminated with pathogenic microorganisms. Considering that tattoo inks are placed into the dermal layer of the skin where anaerobic bacteria can thrive and cause infections in low-oxygen environments, the prevalence of anaerobic and aerobic bacteria should be assessed in tattoo and PMU inks. In this study, we tested 75 tattoo and PMU inks using the analytical methods described in the FDA Bacteriological Analytical Manual Chapter 23 for the detection of both aerobic and anaerobic bacterial contamination, followed by 16S rRNA gene sequencing for microbial identification. Of 75 ink samples, we found 26 contaminated samples with 34 bacterial isolates taxonomically classified into 14 genera and 22 species. Among the 34 bacterial isolates, 19 were identified as possibly pathogenic bacterial strains. Two species, namely Cutibacterium acnes (four strains) and Staphylococcus epidermidis (two strains) were isolated under anaerobic conditions. Two possibly pathogenic bacterial strains, Staphylococcus saprophyticus and C. acnes, were isolated together from the same ink samples (n = 2), indicating that tattoo and PMU inks can contain both aerobic (S. saprophyticus) and anaerobic bacteria (C. acnes). No significant association was found between sterility claims on the ink label and the absence of bacterial contamination. The results indicate that tattoo and PMU inks can also contain anaerobic bacteria. IMPORTANCE: The rising popularity of tattooing and permanent makeup (PMU) has led to increased reports of ink-related infections. This study is the first to investigate the presence of both aerobic and anaerobic bacteria in commercial tattoo and PMU inks under aerobic and anaerobic conditions. Our findings reveal that unopened and sealed tattoo inks can harbor anaerobic bacteria, known to thrive in low-oxygen environments, such as the dermal layer of the skin, alongside aerobic bacteria. This suggests that contaminated tattoo inks could be a source of infection from both types of bacteria. The results emphasize the importance of monitoring these products for both aerobic and anaerobic bacteria, including possibly pathogenic microorganisms.

On the forensic value of tattoos for human identification ­ a literature review / Da importância forense das tatuagens para identificação humana ­ uma revisão da literatura

Disaster victim identification is structured according to international recommendations on the attempt to optimize forensic logistics. The International Criminal Police Organization (INTERPOL) establishes primary and secondary methods for human identification. This study aimed to revisit the existing literature to address the forensic importance of tattoos. The scientific literature has shown advances in the forensic analyses of tattoos specially when it comes to the application of especial imaging techniques, namely photography with infrared light to visualize latent tattoo inks and cover-up tattoos, as well as the use of biochemical processing to distinguish components of the tattoo inks. Other relevant aspect is the fields dedicated to tattoo descriptions in software used worldwide for disaster victim identification, namely PlassData. Coding systems have been proposed as well to facilitate communication in the human identification process. The future of forensic analyses of tattoos is promising considering the increase of research in recent years. Forensic practice might benefit from it with more scientific evidence to support the utilization of tattoo analyses in casework

A identificação de vítimas de desastres em massa é estruturada de acordo com recomendações internacionais na tentativa de otimizar a logística forense. A INTERPOL (International Criminal Police Organization) estabelece métodos primários e secundários para identificação humana. Este estudo teve como objetivo revisitar a literatura existente para abordar a importância forense das tatuagens. A literatura científica tem mostrado avanços nas análises forenses de tatuagens, especialmente no que diz respeito à aplicação de técnicas especiais de imaginologia, como a fotografia com luz infravermelha para visualizar tintas latentes de tatuagens e tatuagens de cobertura, bem como a utilização de processamento bioquímico para distinguir componentes das tintas de tatuagem. Outro aspecto relevante são os campos dedicados à descrição de tatuagens em softwares utilizados mundialmente para identificação de vítimas de desastres em massa, como o PlassData. Sistemas de codificação também foram propostos para facilitar a comunicação no processo de identificação humana. O futuro das análises forenses de tatuagens é promissor considerando o aumento das pesquisas nos últimos anos. A prática forense pode beneficiar-se com mais evidências científicas para apoiar a utilização de análises de tatuagens na condução de casos periciais