Successful Medical Treatment of a Severe Reaction to Red Tattoo Pigment

October 2014 | Volume 13 | Issue 10 | Case Reports | 1274 | Copyright © October 2014


Stephanie Feldstein BAa and Jared Jagdeo MD MSb,c,d

aSchool of Medicine, University of California, San Diego, CA
bDepartment of Dermatology, University of California Davis, Sacramento, CA
cDermatology Service, Sacramento VA Medical Center, Mather, CA
dDepartment of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY

table 1
varying success.1 Ironically, laser removal of tattoos has been reported to stimulate an allergic response itself, as it causes fragmentation of the pigment-containing cells, exposing the pigment to the extracellular environment where it can be recognized as foreign by the immune system.7 It may also result in a systemic allergic response and potentially induce anaphylaxis, though this response has not been well documented in the medical literature.
This case illustrates that is possible to effectively manage a cutaneous tattoo allergy with co-morbid ulceration and infection with medical therapy alone. The treatment plan as outlined above spares patients the discomfort of surgical treatment and circumvents the risk of triggering a systemic allergic reaction with the use of laser modalities. Based on our patient’s success, we believe that medical management is an attractive option, and should be considered as first-line therapy for treating tattoo allergies in patients seeking to preserve the cosmetic integrity of their tattoo.

DISCLOSURES

None of the authors have potential conflicts to declare.

REFERENCES

  1. Juhas E, English JC. Tattoo-associated complications. J Pediatr Adolesc Gynecol. 2013 April; 26(2): 125-9.
  2. Mortimer NJ, Chave TA, Johnston GA. Red tattoo reactions. Clin Exp Dermatol. 2003 Sep; 28(5):508-10.
  3. McGrouther DA, Downie PA, Thomspon WD. Reactions to red tattoos. Br J Plast Surg 1977 Jan; 30 (1): 84-5.
  4. Hubert-Preedy J, Bonhomme K, Hahn B. Female with Rash. Cutaneous tattoo reaction. Ann Emerg Med. 2013 Sep;62(2):275,279.
  5. Sowden JM, Byrne JPH, Smith AG, et al. Red tattoo reactions: X-ray microanalysis and patch test studies. Br J Dermatol 1991 Jun;124 (6): 576-80.
  6. Zwad J, Jakob A, Gross C, Rompel R. Treatment modalities for allergic reactions in pigmented tattoos. J Dtsch Dermatol Ges. 2007 Jan; 5(1): 8-13.
  7. Ashinoff R, Levine VJ, Sotter NA. Allergic reactions to tattoo pigment after laser treatment. Dermatol Surg. 1995 Apr;21(4):291-4.

AUTHOR CORRESPONDENCE

Jared Jagdeo MD MS……........................................ jrjagdeo@gmail.com
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