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Abstract Background Skin modification through tattoos is as old as humanity itself. However, this trend is on the rise, and with the use of different types of pigments and application practices, both cutaneous and systemic complications can arise. Adverse reactions can be grouped into five classes: inflammatory, infectious, neoplastic, aesthetic, and miscellaneous. On histopathology, inflammatory reactions can exhibit a lichenoid pattern or present as spongiotic dermatitis, granulomatous reactions, pseudolymphoma, pseudoepitheliomatous hyperplasia, or scleroderma/morphea-like changes. This article reviews tattoo complications, including their clinical and histopathological characteristics. Methods An open search was conducted on PubMed using the terms "tattoo", "complications", and "skin". No limits were set for period, language, or publication type of the articles. Results Reactions to tattoos are reported in up to 67% of people who get tattooed, with papulonodular and granulomatous reactions being the most common. Some neoplastic complications have been described, but their causality is still debated. Any pigment can cause adverse reactions, although red ink is more frequently associated with them. Patients with pre-existing dermatoses may experience exacerbation or complications of their diseases when getting tattoos; therefore, this procedure is not recommended for this patient group. Conclusions Dermatological consultation is recommended before getting a tattoo, as well as a histopathological examination in case of complications. In patients who develop cutaneous inflammatory reactions following tattooing, additional studies are recommended to investigate systemic diseases such as sarcoidosis, pyoderma gangrenosum, atopic dermatitis, and neoplasms. It is important for physicians to be trained in providing appropriate care in case of complications.
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Background: Chronic viral hepatitis is a major global public health problem, an important cause of morbidity and mortality. We conducted this study to evaluate the behavioral risk factors of HBV infection and its association with HBsAg positivity among residents of Kaza sub-division of district Lahaul & Spiti in Himachal Pradesh. Material & Methods: The study was carried out by the Gastroenterology, Community Medicine, and Microbiology Department at Indira Gandhi Medical College Shimla at Kaza, a subdivision of Lahaul & Spiti. The cluster sampling technique was used to get the desired sample size of 4000. Forty clusters were chosen using a probability proportionate to size sampling method, and 100 research participants were added to each cluster using a simple random sampling method. The data was gathered using a pre-tested interview plan. A blood sample of 5ml from each study participant was obtained, and its HBsAg content was examined. Results: In our study, 2.7% of the interviewed respondents’ parents were positive for hepatitis B and 3.7% reported one positive family member. Injectable drug use was reported by 1.6 (68/4231). Among these users 8.8% (6/68) shared needles with other IDUs in last 12 months and 35.3% (24/68) used a common container to draw up drug solution. Sexual intercourse was reported to be experienced by 15.5 (655/4231) and 12.2% either did not disclose or were children. Out of those who ever experienced sexual/penetrative intercourse 38.3% (251/655) had reported it with someone else other than a spouse. Majority of these had two partners other than a spouse (30.3%; 76/251). Around 30% (195/655) reported of using a condom in their last intercourse. Body piercings or a tattoo from someone who doesn’t sterilize his or her equipment, including local treatment from lamas, was prevalent among 16.3% of the population (689/4231). Acupuncture was taken as a remedy for any medical condition by 9% of participants. Regression analysis also revealed that one infected family member emerged as an independent factor associated with HBsAg positive test after adjusting for confounders. Conclusion: Our study provided much important information concerning hepatitis B risk factors in this tribal group. Health education about behavioral risk factors among this tribal population should be the main intervention that might help limit the spread of these blood-borne infections.
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Objective:To evaluate the preoperative localization value of endoscopic ultrasound guided fine needle tattooing (EUS-FNT) for laparoscopic distal pancreatectomy in pancreatic lesions with a maximum diameter ≤3 cm.Methods:From November 2017 to October 2022, at the Second Affiliated Hospital of Soochow University, the data of patients with pancreatic lesions ≤3 cm who underwent laparoscopic distal pancreatectomy were retrospectively analyzed. Eight patients who underwent EUS-FNT assisted laparoscopic distal pancreatectomy were included in the fine needle tattooing (FNT) combined laparoscopic group. And 14 patients who underwent simple laparoscopic distal pancreatectomy were taken as the simple laparoscopic group. The success rate and complications of EUS-FNT were observed. The differences in operation time, surgery-related complications and complete resection rate of lesions between the two groups were compared. Mann-Whitney U test and descriptive analysis were used for statistical analysis. Results:In the FNT combined laparoscopic group, the lesions of 4 cases were located in the pancreatic body and 4 cases in the pancreatic tail. In the simple laparoscopic group, the lesions of 4 cases were located in the pancreatic body and 10 cases in the pancreatic tail. There was a significant difference in lesion size between the two groups (14.5 mm (10.8 mm, 16.5 mm) vs. 27.0 mm (23.5 mm, 30.0 mm), Z=-3.09, P=0.001). In the FNT combined laparoscopic group, EUS-FNT was successfully performed in all 8 patients. The average time of laparoscopy after EUS-FNT was (98.4±8.8) min. The marks were clearly visible under the laparoscopic field of view, and no complications such as abdominal hemorrhage and hematoma were observed. Laparoscopic pancreaticocaudectomy was performed in 5 cases and pancreaticocaudectomy plus splenectomy in 3 cases. The median operation time was 192.5 min (176.3 min, 203.8 min). The amount of intraoperative bleeding was large in 2 patients and blood transfusion was needed. The lesions were one-time completely resected in all 8 patients. The postoperative pathology were 6 cases of pancreatic neuroendocrine neoplasm, 1 case of intraductal papillary mucinous neoplasm (IPMN), and 1 case of solid pseudopapilloma. In the simple laparoscopic group, laparoscopic pancreaticocaudectomy was performed in 2 cases and pancreaticocaudectomy plus splenectomy in 12 cases. The median operation time was 202.5 min (192.8 min, 235.0 min), which was longer than that of FNT combined laparoscopic group, but the difference was not statistically significant ( P>0.05). The amount of intraoperative bleeding was large in 2 patients and blood transfusion was needed. In 1 patient with pancreatic body lesions, no lesion was found in the specimen examination after the first pancreatectomy, and the lesions were completely resected after the second partial pancreatectomy. Active abdominal hemorrhage occurred in 1 patient on the second day after operation, and underwent interventional embolization for hemostasis. Two weeks after surgery, 1 patient was found to have a encapsulated fluid with a long diameter of 6 cm around the pancreas by computed tomography re-examination 2 weeks after surgery. The postoperative pathology were 5 cases of pancreatic neuroendocrine neoplasm, 2 cases of IPMN, 1 case of solid pseudopapilloma, 1 case of pancreatic cyst with glandular low-grade intraepithelial neoplasia, 1 case of ectopic spleen, and 4 cases of pancreatic ductal adenocarcinoma. Conclusion:EUS-FNT can effectively localize small pancreatic lesions before laparoscopic distal pancreatectomy, shorten the operation time and improve the complete resection rate under laparoscopy.
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RESUMO A ceratopigmentação teve seu primeiro registro pelo filósofo Galeno há muitos séculos como uma estratégia utilizada para o tratamento estético de pacientes com leucomas. As córneas com leucoma são patológicas e, muitas vezes, intolerantes a lentes de contato cosméticas ou próteses oculares, sendo comum a queixa de desconforto excessivo, proporcionado pela superfície corneana irregular. Assim, a ceratopigmentação é uma alternativa para a melhora estética de pacientes com opacidades corneanas. Descrevemos o caso de um paciente do sexo masculino, 39 anos, que apresentou despigmentação precoce em caso de ceratopigmentação associado a quadro de ceratite herpética necrotizante. O paciente foi submetido ao tratamento com aciclovir 2g ao dia e doxiciclina 200mg ao dia, evoluindo com melhora do quadro clínico, apesar da má adesão medicamentosa.
ABSTRACT Keratopigmentation was first recorded many centuries ago by the philosopher Galeno, as a strategy used for the aesthetic treatment of patients with leukomas. Corneas with leucoma are pathological and often intolerant of cosmetic contact lenses or ocular prostheses, with complaints of excessive discomfort provided by the irregular corneal surface being common. Therefore, keratopigmentation is an alternative for the aesthetic improvement of patients with corneal opacities. We describe the case of a 39-year old male patient, who presented early depigmentation in a case of keratopigmentation associated with necrotizing herpetic keratitis. The patient was treated with Acyclovir 2g/day and Doxycycline 200mg/day, evolving with clinical improvement, despite poor medication adherence.
الموضوعات
Humans , Male , Adult , Tattooing/methods , Corneal Neovascularization/etiology , Cornea/surgery , Corneal Opacity/surgery , Coloring Agents/adverse effects , Acyclovir/administration & dosage , Eye Injuries/complications , Cosmetic Techniques , Patient Satisfaction , Keratitis, Herpetic/drug therapy , Doxycycline/administration & dosage , Corneal Opacity/etiology , Estheticsالملخص
Los tatuajes representan una situación in vivo única en la que una gran cantidad de sales metálicas y tintes orgánicos permanecen en la piel durante toda la vida. Como resultado de un mayor número de tatuajes realizados, la incidencia de complicaciones cutáneas asociadas a los tatuajes ha aumentado también. En los últimos 30 años se ha evidenciado un aumento de reportes de tumores cutáneos en los tatuajes; sin embargo, muchos autores siguen considerándolo un evento fortuito. Los posibles efectos cancerígenos locales de los tatuajes siguen sin estar claros. Se cree que este efecto podría ser multifactorial y que combina traumatismo de la aguja, inflamación local crónica, factores externos como la exposición a los rayos ultravioleta (UV) y un posible efecto pro-cancerígeno de las tintas. Se necesitan estudios epidemiológicos y clínicos a gran escala para demostrar esta asociación. Se presenta un caso de un hombre de 40 años, conocido sano, quien 2 meses después de tatuarse el hombro derecho, desarrolla una lesión con características clínicas de un queratoacantoma y a quien se le realiza el diagnostico histológico de un carcinoma espinocelular bien diferenciado e invasor.
Tattoos represent a unique in vivo situation where many metallic salts and organic dyes remain on the skin for a lifetime. As a result of a greater number of tattoos performed, the incidence of skin complications associated with tattoos has increased. In addition, in the last 30 years, there has been an increment in reports of skin tumors within tattoos; however, many authors continue to consider it is a coincidental event. The possible local carcinogenic effects of tattoos remain unclear. It is believed that this effect could be multifactorial, combining needle trauma, chronic local inflammation, external factors such as an ultraviolet rays (UV) exposure and a possible pro-cancer effect of the inks. Large-scale epidemiological and clinical studies are needed to demonstrate this association. A case of a known healthy 40-year-old male is presented, in whom 2 months after a tattoo was performed on his right shoulder, he developed a lesion with clinical characteristics of a keratoacanthoma in which the histological diagnosis of a well differentiated and invasive squamous cell carcinoma was made.
الموضوعات
Humans , Male , Adult , Squamous Cell Carcinoma of Head and Neck/diagnosis , Keratoacanthoma/diagnostic imaging , Tattooing/adverse effects , Costa Rica , Dermatitis/diagnosisالملخص
Este ensaio explora as tatuagens e cicatrizes que se articulam às narrativas sobre viver e conviver com as condições de adoecimento crônico, raro e complexo. Entendemos essas marcas como expressões públicas de um testemunho daqueles afetados pela deficiência e fragilidade da vida, seja como experiência pessoal ou no papel de cuidadores. O corpo como testemunho e suporte performático é explorado na sua dimensão estética e política, na expressão de conteúdos simbólicos que ganham visibilidade na afirmação de identidades e pautas negligenciadas de um público que reivindica reconhecimento e valorização de suas vidas.
This essay explores the tattoos and scars that convey narratives on experiencing and living with chronic, rare, and complex illnesses. We view such marks as public expressions, when individuals bear witness to lives traversed by disability and frailty, whether as their own personal experience or in the role of caregivers. The body as witness and performative support is explored here in its aesthetic and political dimensions, in the expression of symbolic contents that gain visibility in the affirmation of neglected identities and agendas by persons who claim the recognition and valorization of their lives.
Este trabajo investiga los tatuajes y cicatrices que se relacionan con narraciones sobre vivir y convivir con enfermedades crónicas, raras y complejas. Entendemos estas marcas como expresiones públicas de un testigo por parte de quienes se ven atravesados por la deficiencia y fragilidad de la vida, sea como experiencia personal o en el papel de cuidadores. El cuerpo como testigo y soporte performativo es explorado en su dimensión estética y política, como expresión de contenidos simbólicos que ganan visibilidad en la afirmación de identidades y pautas olvidadas de forma negligente, por parte de un público que reivindica reconocimiento y la puesta en valor de sus vidas.
الموضوعات
Humans , Tattooing , Disabled Persons , Brazil , Cicatrixالملخص
RESUMEN El trauma punzante que genera un tatuaje altera la barrera física e inmunológica que proporciona la piel, con lo cual se favorece el ingreso de microorganismos patógenos y el riesgo de sufrir diferentes complicaciones infecciosas. Las condiciones en las que se realiza el tatuaje y el cumplimiento de las normas de bioseguridad son determinantes en prevenir este riesgo, sin embargo, se trata de una práctica de difícil vigilancia y control debido al vacío normativo existente. El auge de los tatuajes permanentes en la sociedad contemporánea se acompaña de un incremento en la frecuencia de sus complicaciones, que suelen ser leves y autoresolutivas, pero también pueden causar graves secuelas y poner en riesgo la salud del paciente tatuado. En la presente revisión se incluyen los principales aspectos normativos y epidemiológicos de los tatuajes, así como las manifestaciones dermatológicas de las infecciones asociadas, su clasificación etiológica y su aproximación diagnóstica y terapéutica.
SUMMARY Puncturing the skin with a tattoo needle damages the immunological and physical barrier. This facilitates the entry of pathogenic microorganisms and the risk of suffering infectious complications. The circumstances around the procedure, sanitary conditions and biosecurity standards are determinants of this risk; however, it is a practice with surveillance and control challenges due to the existing regulatory gap. Because of the significant rise in decorative tattoos among contemporary society, there has been an increase in complications, some are mild and usually resolve on their own, but there are others that leave sequelae and put the health of tattooed patient at risk. This review article includes main local tattooing regulations and epidemiological aspects, as well as dermatological manifestations of infections, their etiological classification, diagnostic and therapeutic approach.
الموضوعات
Humans , Skin , Tattooing , Infectionsالملخص
Abstract Tattooing one's body is currently a common practice worldwide; however, it is not risk-free. This is a case of a patient who tattooed himself motivated by his passion for motorcycles and then developed an exuberant lichenoid reaction to the red pigment used in the tattoo, with the appearance of verrucous lesions. Despite the lack of response to treatment, he states that he would tattoo his own skin again.
الموضوعات
Humans , Male , Tattooing/adverse effects , Lichenoid Eruptions/chemically induced , Skin , Motorcycles , Coloring Agentsالملخص
A prática de tatuagens é muito antiga e atualmente tornou-se extremamente popular, porém traz consigo riscos que não podem ser ignorados. As tintas utilizadas nas tatuagens são um fator importante para o aparecimento de reações adversas. A reação de hipersensibilidade aos pigmentos das tintas é uma das mais comuns. Entre elas, encontram-se reações alérgicas tipo dermatites de contato ou reações de fotossensibilidade, sendo esta última o motivo deste relato. O tratamento indicado é o uso de corticoides e a fotoproteção. Neste artigo, discorreremos especificamente sobre a reação de fotossensibilidade ao pigmento azul, com o relato de um caso e breve revisão da literatura.
Tattooing is a very old practice that has become extremely popular in recent years; however, it carries risks that cannot be ignored. The inks used in tattoos are an important factor for the appearance of adverse reactions. Hypersensitivity reactions to the pigments in the inks are some of the most common. These include allergic reactions such as contact dermatitis or photosensitivity reactions, the latter being the reason for this report. The recommended treatment is the use of corticosteroids and photoprotection. In this article, we will specifically discuss the photosensitivity reaction to the blue pigment with a case report and a brief literature review.
الموضوعات
Humans , Male , Adult , Tattooing , Dermatitis, Photoallergic , Hypersensitivity , Therapeutics , Adrenal Cortex Hormones , Coloring Agents , Histamine Antagonists , Inkالملخص
A tatuagem é uma prática antiga e muito popular atualmente. Os pigmentos utilizados mudaram com o tempo, mas continuam apresentando composições variadas e pouco regulamentadas. Há inúmeros casos descritos de efeitos adversos pós-tatuagem, em sua maioria infecciosos, e reações de hipersensibilidade. Relatamos o caso de uma mulher de 64 anos, hígida, com pápulas nas sobrancelhas um mês após realizar micropigmentação. A biópsia excisional fez o diagnóstico de molusco contagioso, e o tratamento foi realizado com curetagem das lesões. Na literatura, existem poucos relatos de disseminação de molusco contagioso causada por tatuagem.
Tattooing is an ancient practice and very popular nowadays. The pigments used have changed over time but still present varied and poorly regulated compositions. There are many described cases of adverse effects after tattooing, mainly infectious and hypersensitivity reactions. We report the case of a 64-yearold woman, healthy, with papules on her eyebrows one month after performing micropigmentation. The excisional biopsy diagnosed molluscum contagiosum, and the lesions were curetted. There are few reports in the literature of the spread of molluscum contagiosum caused by tattooing
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RESUMEN Antecedentes: la sarcoidosis es una de las reacciones cutáneas asociadas con los tatuajes. Lo más frecuente es que se presente una afección sistémica; dentro de ésta, el compromiso por uveítis y las reacciones sarcoidales asociadas a los tatuajes han sido poco descritas. Caso clínico: hombre de 27 años con cuadro clínico de seis meses de evolución constituido por malestar general, fiebre subjetiva, escalofríos, mialgias, artralgias, tos con expectoración hemoptoica y edema en los miembros inferiores. Se encontró ojo izquierdo rojo, disminución de la agudeza visual y pápulas que infiltraban uno de los tatuajes que se había realizado seis meses antes en el brazo derecho y antebrazo izquierdo. Conclusión: la sarcoidosis asociada a los tatuajes es una condición que requiere de un alto índice de sospecha; donde la infiltración del tatuaje debe hacer pensar al clínico en el diagnóstico para realizar la búsqueda activa del daño orgánico visceral, mucho más en un paciente con uveítis que puede llevar a la ceguera. Aunque inusual, existe esta triple asociación: tatuaje, sarcoidosis sistémica y panuveítis.
SUMMARY Background: One of the cutaneous reactions associated with tattoos is sarcoidosis and the most frequent presentation is systemic involvement; within this, the manifestation of uveitis and sarcoidal reactions associated with tattoos is little described. Clinical case: A 27-year-old man with a clinical picture of six months of evolution consisting of general malaise, subjective fever, chills, myalgias, arthralgias, cough with hemoptysis, edema in lower limbs, and in whom red eye, diminution of visual acuity, and papules that infiltrated one of the tattoos that were placed, six months earlier, on the right arm and left forearm, were found. Conclusion: Sarcoidosis associated with tattooing is a disease that requires a high index of suspicion, where its infiltration should make the clinician suspect the disease and make an active search for systemic involvement, especially in a patient with a uveal compromise that can lead to blindness. It must keep in mind that, although rare, this triple association is possible (tattoo, systemic sarcoidosis, and panuveitis).
الموضوعات
Humans , Adult , Middle Aged , Sarcoidosis , Tattooing , Visual Acuity , Panuveitisالملخص
Carcinoma basocelular sobre a região da tatuagem foi pouco descrito na literatura, com um total de 13 casos. Todos descrevem o aspecto clínico da lesão e sua patogênese, porém não caracterizam a dermatoscopia. Descrevemos dois casos de carcinoma basocelular na tatuagem, com características clínicas e dermatoscópicas, tratados com a cirurgia micrográfica de Mohs. Houve dificuldade em estabelecer as margens clínicas e dermatoscópicas do tumor em decorrência do pigmento exógeno da tatuagem
Basal cell carcinoma over the tattoo region has been poorly reported in the literature, with a total of 13 cases. All cases describe the clinical aspect of the lesion and its pathogenesis but do not characterize the dermoscopy. We report two cases of basal cell carcinoma on tattoos with clinical and dermoscopy features, treated with Mohs micrographic surgery. It was challenging to establish the tumor's clinical and dermoscopic margins due to the tattoo's exogenous pigment
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Abstract Background: Tattooing is among identified risk factor for blood-borne diseases. Objective: This study aims to determine the prevalence of tattooing during lifetime and in prisons and its related factors among Iranian prisoners. Methods: This is a cross-sectional study. The required data was obtained from hepatitis B and C surveillance surveys in prisons in 2015-2016 that was collected through face-to-face interview. 12,800 prisoners were selected by multi-stage random sampling from 55 prisons of 19 provinces in Iran. Weighted prevalence and associated factors (using Chi-Square test and multivariate logistic regression) were determined by Stata/SE 14.0 survey package. Results: Out of 12,800 prisioners, 11,988 participated in the study (93.6% participation rate). The prevalence of tattooing in lifetime and in prisons was 44.7% and 31.1% respectively. The prevalence of tattooing during lifetime was significantly associated with age < 35 years, being single, illiteracy, history of imprisonment, drug use, piercing during lifetime, extramarital sex and history of STI; the prevalence of tattooing in prison had a significant association with history of imprisonment, drug use, piercing in prison, and history of extramarital sex (p < 0.05). Study limitations: Information and selection bias was one of the study limitations. Conclusion: The results of this study showed that the prevalence of tattooing during lifetime and in prison among prisoners was significantly high especially in high-risk groups such as drug users and sexually active subjects. Given the role of tattooing, drug injection and sex in the transmission of blood-borne diseases, harm reduction programs are recommended to reduce these high-risk behaviors in prisons.
الموضوعات
Humans , Male , Female , Adult , Prisoners/statistics & numerical data , Tattooing/statistics & numerical data , Risk-Taking , Socioeconomic Factors , Tattooing/adverse effects , Time Factors , Logistic Models , Prevalence , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Sex Distribution , Age Distribution , Substance-Related Disorders/epidemiology , Body Piercing/statistics & numerical data , Iran/epidemiology , Middle Agedالملخص
Lasers Q-switched são os mais utilizados para remoção de tatuagens. Paciente feminina, de 48 anos, passou por consulta para remoção de tatuagem preta na coxa esquerda. Foram realizadas dez sessões de laser Q-switched Nd:YAG 1064nm associado ao laser de CO2 fracionado com intervalos de 60 dias entre elas. Seis meses após a última sessão, houve remoção praticamente completa do pigmento, além de melhora da textura da pele. Lasers Q-switched removem tatuagens por meio do fenômeno fotoacústico. A associação com lasers fracionados ablativos é opção para tratamento de tatuagens com grande quantidade de pigmento ou em tatuagens com muitas cores, de difícil remoção.
Q-switched lasers are widely used for tattoo removal. A 48-year-old-woman with a black tattoo on the left thigh was submitted to ten sessions of Q-switched Nd:YAG 1064nm laser associated with fractional CO2 laser, performed every two months. Six months after treatment end, we observed almost complete tattoo removal, besides improvement in skin texture. Q-switched lasers promote tattoo removal by a photoacoustic phenomenon. The association with fractional ablative lasers is an option for intensely pigmented tattoos or for tattoos with several colors, which are hard to remove.
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Abstract The number of individuals with tattoos has been increasing worldwide, alongside with reports of complications varying from reactions to the injected pigments to infections caused by agents inoculated in the pigmentation process. The diagnosis of such unwanted events can be obtained through complementary non-invasive methods, preserving the maximum of the tattoo design. The authors present two cases of patients with warts on tattooing, and correlate their clinical aspects to in vivo and ex vivo dermoscopy, and to the findings in the histopathological examination, aiming to determine patterns that aid the diagnosis of these lesions without performing biopsy.
الموضوعات
Humans , Male , Adult , Tattooing/adverse effects , Warts/pathology , Warts/diagnostic imaging , Papillomavirus Infections/pathology , Papillomavirus Infections/diagnostic imaging , Biopsy , Warts/virology , Papillomavirus Infections/virology , Dermoscopy/methods , Coloring Agents/adverse effects , Epidermis/pathology , Epidermis/virologyالملخص
Objective@#To explore the application of endoscopic tattooing with carbon nanoparticles in the treatment of advanced colorectal cancer (ACRC).@*Methods@#A randomized controlled study was used. Inclusion criteria: (1) age more than 18 years old, and colorectal cancer was found for the first time and confirmed by colonoscopy and biopsy; (2) advanced colorectal cancer (preoperative TNM stage of T3/N1 or above, local unresectable lesion, M1 stage and simultaneously resectable metastatic lesion), and patients agreed to receive neoadjuvant therapy; (3) advanced colorectal cancer (TNM stage of T3/N1 or above) with simultaneous unresectable metastatic lesion, and patients refused operation and consented to chemoradiotherapy. Patients with previous abdominal surgery history, radiotherapy and chemotherapy history, urgent need for surgery or endoscopic stent placement and those with severe allergic constitution were excluded. Based on the above criteria, 120 patients diagnosed with ACRC in No.900 Hospital of the Joint Logistics Team from January 2016 to December 2017 were prospectively enrolled and randomly divided into tattoo group and non-tattoo group by random number table method. Tattoo group were tattooed within 1-7 days before chemoradiotherapy. The labeling location of the lesions: (1) if the colonoscopy could pass smoothly, 4 points were injected into the intestinal wall of the both opposite sides 1 cm cephalad and caudad of the tumor; (2) if the colorectal cavity was severely narrow and the colonoscopy could not pass, only 4 points were injected in 4 quadrants at 1 cm caudad of the tumor. Each injection point was injected with 0.1 ml carbon nanoparticles, and the size of the tumor was measured according to the range of carbon nanoparticles staining. The efficacy was evaluated after 8 weeks of chemoradiotherapy. Patients who were defined to be suitable for operation underwent operation 6 weeks after chemoradiotherapy. The following parameters were compared between two groups: lesion identification time, operation time, blood loss, distance from lesion to distal margin, the rate of first positive margin and the rate of anal sphincter preservation (rectal cancer). Among patients who had been evaluated as having no indication for surgery, those who were effective in chemoradiotherapy continued to receive chemotherapy in the original regimen; if the treatment failed, the chemotherapy regimen was replaced, and the efficacy was finally evaluated after six months [referring to the revised RECIST guidelines (version 1.1)].@*Results@#Three patients withdrew from this study, and 117 patients were enrolled in this study finally, including 59 cases in tattoo group and 58 cases in the non-tattoo group. There were no significant differences in baseline data between two groups (all P>0.05). All the patients had slight adverse reactions of radiotherapy and chemotherapy before operation, and could tolerate after symptomatic management without interruption of treatment. All the patients in the tattoo group had no discomfort such as fever, abdominal pain, abdominal distention, hematochezia, etc. and the intestinal mucosa could be seen clearly with black staining after being tattooed. A total of 77 patients were evaluated with surgical indications, including 39 cases in the tattoo group (tattoo-operable) and 38 cases in the non-tattoo group (non-tattoo-operatable). There were no significant differences in baseline data between the two groups (all P>0.05). Forty patients without operation indications continued chemoradiotherapy, including 20 cases in tattoo group (tattoo-inoperable) and 20 cases in non-tattoo group (non-tattoo-inoperable), whose differences in baseline data between the two groups were not significant as well (all P>0.05). No obvious edema, necrosis or abscess were found in the tattooed segments and the black spots could be seen quickly and clearly on the serosa of rectum in tattoo-operable patients. As compared to non-tattoo group, tattoo group had significantly shorter lesion identification time [(3.4±1.4) minutes vs. (11.8±3.4) minutes, t=-14.07,P<0.001], shorter operation time [(155.7±44.5) minutes vs. (177.2±30.2) minutes, t=-2.48,P=0.015], less blood loss [(101.3±36.7) ml vs.(120.2±38.2) ml, t=-2.22,P=0.029], shorter distance from lesion to distal margin [(3.7±1.0) cm vs. (4.6±1.7) cm, t=-2.20, P=0.034], while tattoo group had slightly higher rate of anal sphincter preservation [66.7%(16/24) vs. 45.5%(10/22), χ2=2.10,P=0.234] and lower rate of first positive resection margin [0 vs. 4.5%(1/22), χ2=0.62,P=0.480], but their differences were not significant. There were no significant differences in the degree of tumor differentiation and TNM stage between two groups. Patients without operative indication were evaluated for efficacy of chemoradiotherapy again after half a year. One case of complete response (CR), 8 of partial response (PR), 10 of stable disease (SD) and 1 of progressive disease (PD) were found and the improvement rate was 45.0% (9/20) in tattoo-inoperable patients. No case of CR, 6 of PR, 11 of SD and 3 of PD were found and the improvement rate was 30.0% (6/20) in non-tattoo-inoperable patients. There was no significant difference in the improvement rate between the two groups (P=0.514).@*Conclusions@#Endoscopic tattooing with carbon nanoparticles injection is safe and reliable for colorectal tumor positioning. It can assist rapid detection of lesions during surgery after neoadjuvant treatment, perform accurate resection, significantly shorten the operation time and reduce surgical trauma; can assist colonoscopy accurately to measure the size of the lesions before and after chemoradiotherapy, and increase the means of assessing the efficacy to guide the follow-up treatment plan. This technique is worth clinical promotion and application.
الملخص
Mília são cistos de queratina de 1-3mm de diâmetro, que ocorrem devido à obstrução de glândulas sudoríparas écrinas ou de folículos pilosos. Descrevemos um caso em paciente feminina, com múltiplas pápulas branco-amareladas, distribuídas sobre uma tatuagem realizada seis meses antes da consulta médica. O tratamento conservador é uma opção, uma vez que há a possibilidade de que a lesão seja transitória e desapareça espontaneamente. Optamos por tratamento conservador com ótimo resultado estético final.
Milia are keratin cysts of 1-3mm in diameter that occur due to the obstruction of eccrine sweat glands or hair follicles. We describe the case of a female patient with multiple white-yellow papules over a tattoo made six months prior to the consultation. Conservative treatment is an option, since there is the possibility of the lesion being transient and that it will spontaneously resolve. We opted for a conservative treatment with excellent final cosmetic outcome.
الموضوعات
Conservative Treatmentالملخص
INTRODUCTION@#The study aimed to determine the association of body tattooing and health risk behaviors among young adult Filipinos in a university in Metro Manila, as previous studies have linked tattooing to health risk behaviors such as alcoholism, violence, suicidality, illegal drug use and smoking.@*METHODS@#A convenience sample of students enrolled in randomly selected colleges from a university were recruited for the study. Researchers administered the Youth Risk Behavior Survey to the participants. Prevalence rate ratios were computed, and chi-square was utilized to test for significance and strength of association of the variables mentioned.@*RESULTS@#Among the risk behaviors studied, only smoking had a significant association with tattooing, with tattooed individuals being two times more likely to be engaged in smoking. Alcoholism, violence, suicidality and illegal drug use did not show significant associations with tattooing. @*CONCLUSION@#The presence of body tattoos was associated with increased engagement in smoking behaviors, though the association between tattooing and other risk behaviors should be further explored.
الملخص
The nipple-areolar complex (NAC) reconstruction is the final touch in the reconstructive breast surgery, and it is very important for the patient's psychological health and satisfaction. There are many described techniques, but the main issue is to maintain the NAC projection over the time. The local graft reconstruction together with tattooing are the most popular techniques. However, it is important to personalize the method taking into account the patient's characteristics and the breast mound reconstruction to achieve good results. This article describes the reconstruction planning method, nipple and areolar reconstruction techniques using nipple sharing, local and autologous grafts and tattooing.
A reconstrução do complexo aréolo-papilar (CAP) é o toque final da cirurgia de reconstrução mamária sendo parte importante na satisfação e saúde psicológica da paciente. Existem várias técnicas descritas, porém o maior desafio é a manutenção da projeção do mamilo ao longo do tempo. As técnicas mais utilizadas são as que utilizam enxertos locais com posterior tatuagem. Entretanto, é importante a individualização do tratamento, a técnica escolhida deve levar em consideração as características da paciente e da mama reconstruída para que o resultado final seja satisfatório. O presente artigo descreve método de planejamento, técnicas de reconstrução da aréola e do mamilo utilizando enxertos de retalho local, autólogo ou do mamilo contralateral e tatuagem
الملخص
Introdução: A reconstrução do complexo areolopapilar (CAP) é etapa fundamental no tratamento do câncer de mama. Tipicamente, é realizada em dois tempos distintos, sendo primeiro a papila reconstruída e somente após sua completa cicatrização que a tatuagem é realizada. Métodos: Estudo retrospectivo realizado no período de 2015 a 2016 no Hospital São Lucas da PUCRS. Foram incluídas 21 pacientes com ausência do CAP unilateral. É descrita a técnica de reconstrução da papila com retalho local em C-V associado à tatuagem para pigmentação do CAP em tempo único. Foram apresentados os dados referentes ao tipo de reconstrução mamária realizada, às complicações e à presença de radioterapia prévia. Resultados: A maioria das pacientes foi reconstruída com implante (48%). Houve três complicações relacionadas à papila (14%), uma necrose parcial e duas deiscências pequenas. Não houve complicação relacionada à tatuagem. Onze pacientes (52%) haviam realizado radioterapia prévia na mama. Conclusão: A tatuagem associada ao retalho em C-V em tempo único é uma técnica simples e com baixo índice de complicações.
Introduction: Reconstruction of the nipple-areola complex (NAC) is a fundamental step in the treatment of breast cancer. It is usually performed in two distinct stages. Tattooing is performed only after reconstruction and complete scarring of the nipple. Methods: This retrospective study was conducted from 2015 to 2016 at the Hospital São Lucas of the Pontifical Catholic University of Rio Grande do Sul. Twenty-one patients with a single NAC were included. One-stage reconstruction of the nipple using a local C-V flap associated with tattooing for pigmentation of the NAC is described. Data on the type of breast reconstruction performed, associated complications, and presence of previous breast radiotherapy were presented. Results: Most patients (48%) underwent reconstruction with an implant. Three complications (14%) were observed in the nipple, including one case of partial necrosis and two cases of small dehiscence. None of the patients had complications due to tattooing. Eleven patients (52%) underwent breast radiotherapy previously. Conclusion: Tattooing combined with one-stage reconstruction using a C-V flap is a simple technique with a low rate of complication.