RESUMO
IMPORTANCE: Local and generalized allergic reactions following laser tattoo removal have been documented, but are rare. To our knowledge, this is the fourth documented case of widespread urticarial eruptions following laser tattoo removal treatment. Unlike previously documented cases, this patient's reaction was found to be associated with titanium dioxide within the tattoo and her symptoms were recalcitrant to medical therapy. OBSERVATIONS: A 46-year-old female experienced diffuse urticarial plaques, erythema, and pruritis following multiple laser tattoo removal treatments with an Nd:YAG laser. The systemic allergic reaction was recalcitrant to increasing doses of antihistamines and corticosteroids. The tattoo was finally surgically excised. The excised tissue was analyzed by scanning electron microscopy and energy-dispersive X-ray analysis and contained high levels of titanium dioxide. Two weeks following the excision, and without the use of medical therapy, the patient had complete resolution of her generalized urticaria. CONCLUSIONS: Ours is the first documented case of a diffuse urticarial reaction following laser tattoo removal treatments that shows a strong association to titanium dioxide within the tattoo pigment. Herein, we describe a novel surgical approach to treat recalcitrant generalized allergic reaction to tattoo pigment.
Assuntos
Lasers de Estado Sólido/efeitos adversos , Tatuagem , Titânio/efeitos adversos , Urticária/etiologia , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Miofibroma/patologia , Couro Cabeludo , Neoplasias Cutâneas/patologia , Biópsia por Agulha , Humanos , Imuno-Histoquímica , Recém-Nascido , Masculino , Monitorização Fisiológica , Miofibroma/diagnóstico por imagem , Prognóstico , Remissão Espontânea , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia DopplerRESUMO
We report a patient with carcinomatous meningitis secondary to known transitional cell carcinoma of the bladder. The patient presented with multiple focal neurological signs and symptoms. Diagnosis was suggested by magnetic resonance imaging and confirmed by analysis of the cerebrospinal fluid. He received whole brain radiotherapy despite a poor prognosis. To our knowledge, this is only the fifth reported case of neoplastic meningitis due to bladder cancer with confirmatory imaging and cytology and only the fourth reported case that presented with cranial nerve involvement.
