Tattoos: risks and complications, clinical and histopathological approach

Area of Science:

• Dermatology
• Pathology

Background:

• Tattooing is a widespread practice with potential for cutaneous and systemic complications.
• Adverse reactions are categorized into inflammatory, infectious, neoplastic, aesthetic, and miscellaneous types.
• Histopathological findings in inflammatory reactions include lichenoid patterns, spongiotic dermatitis, granulomatous reactions, and others.

Purpose of the Study:

• To review the clinical and histopathological characteristics of tattoo complications.
• To highlight the prevalence and types of adverse reactions associated with tattooing.

Main Methods:

• An open search of PubMed was performed using keywords: "tattoo", "complications", and "skin".
• No restrictions were placed on publication period, language, or type.

Main Results:

• Up to 67% of tattooed individuals experience reactions, most commonly papulonodular and granulomatous.
• Red tattoo ink is frequently linked to adverse reactions.
• Neoplastic complications are reported, though causality remains debated.
• Tattooing can exacerbate pre-existing dermatoses, making it inadvisable for such patients.

Conclusions:

• Pre-tattoo dermatological consultation and histopathological examination for complications are advised.
• Investigating systemic diseases like sarcoidosis, pyoderma gangrenosum, atopic dermatitis, and neoplasms is recommended for inflammatory reactions.
• Physician training in managing tattoo complications is crucial.