[Reaction patterns to cutaneous particulate and ornamental tattoos]

Particulate matter incorporated into the skin of former miners was compared to ornamental tattoos with regard to composition and cutaneous reaction pattern. The specimens were examined histologically and immunohistochemically followed by scanning electron microscopy and element analysis. In the skin biopsies containing dirt particles, silicon and aluminium were regularly found and the particles were positively birefringent under the light microscope. Even years after the initial foreign particle incorporation strong reactions against quartz-containing substances deposited perivascularly and perifollicularly continued to take place. Reactions ranged from strong macrophage activation to pre-granulomatous changes. Anthracotic pigment was demonstrated in all layers of the dermis depending on the degree of traumatic insult and the colour pigments of the ornamental tattoos showed a variable spectra of elements depending on the type of dye used. Fibrous reactions were only discrete, however, strong macrophage activation and sometimes capillary proliferation as well as non-specific lymphocytic infiltration could still be confirmed even decades after the initial incorporation. In conclusion, the cutaneous incorporation of ornamental tattoo dyes and accidental dirt particles is not an inert process. Even years later, non-specific macrophage activation as well as discrete inflammatory changes in an attempt to degrade the foreign material can still be documented. A clear correlation between subcutaneous incorporated quartz particles and progressive systemic sclerosis was not found in this study.