Eruptive Milia Within a Tattoo: A Case Report and Review of the Literature

June 2017 | Volume 16 | Issue 6 | Case Reports | 621 | Copyright © June 2017


Nicholas Ross, Michele Farber MD, and Joya Sahu MD

Thomas Jefferson University, Phladelphia, PA

Figure4Figure5disrupts adnexal structures. Additionally, application of a tattoo produces an acute, aseptic inflammatory reaction. A prior report of milia within a lichenoid tattoo reaction showed disruption of adnexal structures on histology.15 This trauma, therefore, is akin to that of secondary milia formation. Moreover, post-tattoo care regimens, such as ointment massage and occlusion, may increase accumulation of keratin debris within the needle wounds and follicular ostia. Although this may further follicular obstruction and milia formation, there are likely other factors involved, as these care regimens would likely affect normal adjacent skin.While the condition is benign and self-limited, patients often request therapy secondary to aesthetic concerns. In cases with few lesions, a needle or scalpel can be used to express individual cysts. Keratolytics, such as tretinoin, urea, and salicylic acid, have been used to reduce ostial plugging by normalizing epidermal maturation. They hasten resolution through exfoliation. Non-ablative and ablative lasers can also improve milia within tattoos, but are likely to disrupt the design clarity and pigment, making this a less favorable treatment.In summary, this case of eruptive milia in a tattoo demonstrates an exceedingly rare complication of skin-inking. It is important for clinicians to be able to distinguish this reaction from others that likely require more aggressive therapy. As tattooing is a trend on the rise, dermatologist can expect to see an increased number of tattoo-related dermatoses in their practice.14

DISCLOSURES

All authors have no relevant financial interests, relationships, or affiliations to disclose.

REFERENCES

  1. Ravits H. Allergic Tattoo Granuloma. Arch Dermatol. 1962;86(3):287-289.
  2. Kluger N, Cohen P, Fallet-Bianco C, Guillevin L. Mycobacterium chelonae infection under adalimumab therapy for spondylarthritis. Clin Exp Rheumatol. 2010;28(1):101-102.
  3. Samuel MC, Doherty PM, Bulterys M, Jenison SA. Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA. Epidemiol Infect. 2001;127(3):475-484.
  4. Schwartz RA, Mathias CG, Miller CH, Rojas-Corona R, Lambert WC. Granulomatous reaction to purple tattoo pigment. Contact dermatitis. 1987;16(4):198-202.
  5. Sowden JM, Cartwright PH, Smith AG, Hiley C, Slater DN. Sarcoidosis presenting with a granulomatous reaction confined to red tattoos. Clin Exp Dermatol. 1992;17(6):446-448.
  6. Kazandjieva J, Tsankov N. Tattoos: dermatological complications. Clin Dermatol. 2007;25(4):375-382.
  7. Sanghavi SA, Dongre AM, Khopkar US. Tattoo reactions--an epidemic on the surge: a report of 3 cases. Indian J Dermatol Venereol Leprol. 2013;79(2):231-234.
  8. Bjornberg A. Reactions to Light in Yellow Tattoos from Cadmium Sulfide. Arch Dermatol. 1963;88:267-271.
  9. Marchesi A, Parodi PC, Brioschi M, et al. Tattoo Ink-Related Cutaneous Pseudolymphoma: A Rare but Significant Complication. Case Report and Review of the Literature. Aesthetic Plast Surg. 2014;38:471.
  10. La Placa M, Passarini B. Subacute cutaneous lupus erythematosus after a tattoo. Clin Exp Dermatol. 2009;34(5):632-633.
  11. West CC, Morritt AN, Pedelty L, Lam DG. Cutaneous leiomyosarcoma arising in a tattoo - ‘a tumour with no humour’. J Plast Reconstr Aesthet Surg. 2009;62(5):e79-80.
  12. Smith SF, Feldman SR. Tattoo sites and psoriasis. J Drugs Dermatol. 2011;10(10):1199-1200.
  13. Horner KL, Chien AJ, Edenholm M, Hornung RL. Winnie the Pooh and psoriasis too: an isomorphic response of guttate psoriasis in a tattoo. Pediatr Dermatol. 2007;24(5):E70-72.
  14. Juhas E, English JC, 3rd. Tattoo-associated complications. J Pediatr Adolesc Gynecol. 2013;26(2):125-129.
  15. Lucke T, Fallowfield M, Burden D. Lichen planus associated with milia. Clin Exp Dermatol. 1999;24(4):266-269.
  16. Epstein W, Kligman AM. The pathogenesis of milia and benign tumors of the skin. J Invest Dermatol. 1956;26(1):1-11.
  17. Koh MJ, Teo RY, Liu TT. Multiple epidermal cysts occurring in a tattoo. Singapore Med J. 2009;50(11):e376-377.
  18. Miller LM, Schwartz JT, Cho S. Milia: a unique reaction to tattoos. Cutis. 2011;87(4):195-196.

AUTHOR CORRESPONDENCE

Nicholas A. Ross E-mail:................................................... [email protected]
Close Menu