Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism.

BACKGROUND: The majority of tattoo reactions are affiliated to red pigmented areas and often suspected to be allergic in nature. A sizeable series of biopsies of such reactions has not previously been performed. The aim of this study was to type and grade epidermal and dermal changes in tattoo reactions to red/red nuances by microscopy and immunochemistry relevant for the assessment of a possible allergic pathomechanism. METHODS: Skin biopsies were taken from red tattoo reactions, graded by conventional microscopy and stained for T and B-lymphocytes, Langerhans cells, macrophages and tumour necrosis factor (TNF)-α. RESULTS: The study included 19 biopsies from 19 patients. The culprit colours were red/pink (n = 15) and purple/bordeaux (n = 4). Interface dermatitis was clearly the lead pathology found in 78% of samples, overlapped with granulomatous (in 32%) and pseudolymphomatous reaction patterns (in 32%). Epidermal hyperkeratosis (in 89%) was common as was leakage of red pigment across the dermo-epidermal junction, with transepidermal elimination (in 28%). The dermal cellular infiltration was dominated by T-lymphocytes (in 100%), Langerhans cells (in 95%) and macrophages (in 100%). TNF-α was common. CONCLUSION: The predominant histological pattern of chronic tattoo reactions in red/red nuances is interface dermatitis. T-lymphocytes and Langerhans cells are increased suggesting an allergic pathomechanism. TNF-α may contribute to reactions. In many cases, overlapping reactive patterns were identified.

Microbial status and product labelling of 58 original tattoo inks.

BACKGROUND: European Council resolutions on tattoo ink introduce sterility and preservation of inks to protect customers. Inks used in Denmark are typically purchased over the internet from international suppliers and manufacturers from the US and the UK. In Denmark tattoo inks are regulated and labelled according to REACH as if they were plain chemicals. OBJECTIVE: The objective of this study was to check the microbial product safety of unopened and opened tattoo ink stock bottles. Packaging, labelling, preservation, sterility and contamination with micro-organisms were studied. METHODS: Physical inspection and culture of bacteria and fungi. RESULTS: Six of 58 unopened stock bottles (10%) were contaminated with bacteria and one of six samples (17%) of previously used stock bottles was contaminated. The bacterial species represented bacteria considered pathogenic in humans as well as non-pathogenic environmental bacteria. Yeast or moulds were detected in none of the samples. A total of 31% of the manufacturers informed only about the brand name. No information about content, sterility, risks or expiry date was indicated on the label. A total of 42% claimed sterility of their inks. A total of 54% labelled a maximum period of durability of typically 2-3 years. The physical sealing was leaking in 28% of the products. CONCLUSIONS: The European Council resolutions regarding safety of tattoo inks are not effective. Stock bottles of tattoo ink may contain bacteria pathogenic to humans and environmental bacteria, and packaging, labelling and preservation of inks are of inadequate quality. Claim of sterility can be erroneous.

High prevalence of minor symptoms in tattoos among a young population tattooed with carbon black and organic pigments.

BACKGROUND: The prevalence of mild adverse reactions, i.e. complaints, in tattoos is sparsely described. OBJECTIVE: The demography of tattoos in a young population representing an index population of the recent trend was studied. The prevalence of complaints related to tattoos, and tattoos by number, size, localization and colour were registered. METHODS: The data were collected through personal interviews and examinations of consecutive individuals who spontaneously attended a clinic of venereology. RESULTS: Of 154 participants with 342 tattoos, 27% reported complaints in a tattoo beyond 3 months after tattooing. The complaints were predominantly related to black and red pigments. The participants reported complaints in 16% of their tattoos. Fifty-eight per cent of those complaints were sun induced. The complaints varied in intensity but were mainly minor. Skin elevation and itching were most frequent. The responders stated overall satisfaction with 80% of all tattoos. Eight per cent of tattoos were situated on anatomical sites prohibited by Danish law. CONCLUSION: We found a remarkably high prevalence of tattoo complaints, including photosensitivity, among young individuals tattooed with carbon black and organic pigments especially red.

Tattoo inks in general usage contain nanoparticles.

BACKGROUND: To our knowledge tattooing has never been thought of as a method of introducing nanoparticles (NPs) into the human body by the intradermal route, and as such it has never been a topic of research in nanotoxicology. The content of NPs in tattoo inks is unknown. OBJECTIVES: To classify the particle sizes in tattoo inks in general usage. METHODS: The particle size was measured by laser diffraction, electron microscopy and X-ray diffraction. RESULTS: The size of the pigments could be divided into three main classes. The black pigments were the smallest, the white pigments the largest and the coloured pigments had a size in between the two. The vast majority of the tested tattoo inks contained significant amounts of NPs except for the white pigments. The black pigments were almost pure NPs, i.e. particles with at least one dimension <100 nm. CONCLUSIONS: The finding of NPs in tattoo inks in general usage is new and may contribute to the understanding of tattoo ink kinetics. How the body responds to NP tattoo pigments should be examined further.