Diagnostic Approach for Suspected Allergic Cutaneous Reaction to a Permanent Tattoo.

The last few decades have seen a notable increase in the number of people who have a tattoo. This practice is not free from complications. Most adverse effects appear early and are temporary, although they can occasionally develop later and be permanent and serious. Recent research has generated new knowledge on the composition of inks, their degradation over time, the immune activity that is stimulated, and the various clinical disorders that can arise. This information enables better approaches to diagnosis and management when complications arise. Diagnosing allergic reactions to permanent tattoo ink can be very challenging. This review aims to identify clinical and histological clues to help practitioners differentiate allergic reactions from other complications. We discuss the yield and appropriateness of skin tests and biopsies and propose an algorithm to guide the diagnostic process.

Diagnostic approach for suspected allergic cutaneous reaction to a permanent tattoo

The last few decades have seen a notable increase in the number of people who have a tattoo. This practice is not free from complications. Most adverse effects appear early and are temporary, although they can occasionally develop later and be permanent and serious. Recent research has generated new knowledge on the composition of inks, their degradation over time, the immune activity that is stimulated, and the various clinical disorders that can arise. This information enables better approaches to diagnosis and management when complications arise. Diagnosing allergic reactions to permanent tattoo ink can be very challenging. This review aims to identify clinical and histological clues to help practitioners differentiate allergic reactions from other complications. We discuss the yield and appropriateness of skin tests and biopsies and propose an algorithm to guide the diagnostic process

En las últimas décadas ha aumentado ostensiblemente el número de personas que se realiza un tatuaje en la piel. Esta técnica no está exenta de complicaciones. La mayoría son precoces y transitorias, pero, en ocasiones, son tardías, permanentes y graves. En los últimos años, los avances en el conocimiento de la composición de tintas, de los procesos de degradación de las mismas tras el tatuado, de la actividad inmunitaria que se desencadena y la descripción de una clasificación en patrones clínicos, nos han permitido realizar un mejor enfoque diagnóstico y manejo terapéutico de estas complicaciones. El diagnóstico de las reacciones alérgicas a las tintas de los tatuajes permanentes supone un verdadero reto. En esta revisión intentaremos dar claves clínicas e histológicas que nos ayudan a diferenciar las reacciones alérgicas del resto de complicaciones. Discutiremos la rentabilidad e idoneidad de las pruebas epicutáneas y de la biopsia cutánea, y propondremos un algoritmo diagnóstico

¿Qué procedimientos diagnósticos deberíamos realizar ante una sospecha de reacción alérgica a un tatuaje? Propuesta basada en nuestra casuística / Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital

INTRODUCCIÓN: Los tatuajes se han convertido en una práctica muy popular en los países occidentales, sobre todo entre los más jóvenes. Las complicaciones asociadas a esta técnica incluyen procesos infecciosos, alérgicos, reacciones a cuerpo extraño e incluso procesos inflamatorios sistémicos. PACIENTES Y MÉTODOS: Se ha realizado un estudio retrospectivo de todos los pacientes que acudieron a la consulta de Alergia cutánea por manifestar complicaciones en un tatuaje desde enero de 2002 a diciembre de 2016. RESULTADOS: Se han incluido a 23 pacientes. De ellos, 9 presentaron complicaciones de forma precoz y en todos ellos la etiología fue infecciosa. De los 14 pacientes con reacciones tardías, 10 fueron diagnosticados de probable dermatitis de contacto alérgica a la tinta, sin embargo solo en 3 de los casos se pudo apuntar al alérgeno probablemente culpable y tan solo en uno de ellos se pudo demostrar. Se detectaron dos casos de sarcoidosis cutánea, uno de reacción granulomatosa a cuerpo extraño, y un caso de reacción neuropática en una paciente. CONCLUSIONES: Las complicaciones asociadas a los tatuajes son un motivo de consulta relativamente frecuente en las consultas de Dermatología. Proponemos un algoritmo diagnóstico basado en nuestra casuística, que ayude a orientar las distintas reacciones a tatuaje y con ello a iniciar las medidas terapéuticas oportunas

INTRODUCTION: Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS: We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS: We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS: Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment

Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital. / ¿Qué procedimientos diagnósticos deberíamos realizar ante una sospecha de reacción alérgica a un tatuaje? Propuesta basada en nuestra casuística.

INTRODUCTION: Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS: We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS: We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS: Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment.