ABSTRACT
BACKGROUND: Tattooing has been around for many years and is becoming an increasingly common fashion trend. As there are often few regulatory laws regarding the practice, an increase in the incidence of cutaneous reactions to tattoo inks is noted. These include allergic reactions, granulomatous dermatitis, infections, lichenoid dermatoses, and sometimes malignancy. The present study examines the histopathological changes seen in patients with cutaneous reactions to tattoo ink. METHOD: A prospective observational study was conducted over 18 months in the dermatology clinic of a tertiary care center in western India. The study population included 22 patients with cutaneous reactions over the tattoos. Punch biopsy specimens were sent to study the pattern of histopathological response. RESULTS: All 22 patients studied were between the ages of 17 and 35 years. The mean duration of development of reaction was 8.1 months. Most of the reactions were seen in black ink tattoos performed by amateurs. Perivascular and spongiotic dermatitis suggestive of allergic response was the most common feature on histopathology. Granulomatous response and lichenoid response were seen in five and three biopsies, respectively. CONCLUSION: Legalization is needed for this practice to prevent tattoo reactions. Histopathological evaluation is important as tattoo reactions may be associated with skin infections and malignancies.
Subject(s)
Biopsy, Needle/methods , Skin Diseases/etiology , Skin Diseases/pathology , Tattooing/adverse effects , Adolescent , Adult , Female , Granuloma/diagnosis , Granuloma/epidemiology , Granuloma/etiology , Humans , Hypersensitivity/diagnosis , Hypersensitivity/epidemiology , Hypersensitivity/etiology , Hypersensitivity/prevention & control , India/epidemiology , Infections/diagnosis , Infections/epidemiology , Infections/etiology , Ink , Lichenoid Eruptions/diagnosis , Lichenoid Eruptions/epidemiology , Lichenoid Eruptions/etiology , Male , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/etiology , Prevalence , Prospective Studies , Skin Diseases/epidemiology , Tattooing/legislation & jurisprudence , Tattooing/statistics & numerical data , Tertiary Care Centers , Young AdultABSTRACT
Angiokeratomas are variable sized hyperkeratotic vascular papules that are characterized histologically by superficial dilated capillaries in papillary dermis with epidermal proliferation. They can occur as a single lesion to a generalized form (angiokeratoma corporis diffusum). Angiokeratoma corporis diffusum though initially synonymous with Anderson Fabry disease, is now known to occur in a variety of lysosomal enzyme deficiencies. We report a case of 22 year old male with angiokeratoma corporis diffusum associated with acroparesthesias, febrile episodes, sensorineural hearing loss and renal involvement. Histopathological evaluation showed characteristic ectatic blood vessels with vacuolated endothelial cells in papillary dermis. Based on the clinical evaluation and available investigations, we suspected him to be having to Anderson fabry disease. Resource constraints limited our ability to confirm our diagnosis with enzyme assay and electron microscopy. We report this unusual case in desire of re emphasizing the importance of clinical evaluation for reaching a diagnosis in a resource poor setting.