Premium
Are metals involved in tattoo‐related hypersensitivity reactions? A case report
Author(s) -
de Cuyper Christa,
Lodewick Evelyne,
Schreiver Ines,
Hesse Bernhard,
Seim Christian,
CastilloMichel Hiram,
Laux Peter,
Luch Andreas
Publication year - 2017
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.12862
Subject(s) - medicine , biopsy , nickel allergy , dermatology , skin biopsy , patch testing , patch test , allergy , culprit , hypersensitivity reaction , dentistry , contact dermatitis , pathology , immunology , myocardial infarction
Summary Background Allergic reactions to tattoos are not uncommon. However, identification of the culprit allergen(s) remains challenging. Objectives We present a patient with papulo‐nodular infiltration of 20‐year‐old tattoos associated with systemic symptoms that disappeared within a week after surgical removal of metal osteosynthesis implants from his spine. We aimed to explore the causal relationship between the metal implants and the patient's clinical presentation. Methods Metal implants and a skin biopsy of a reactive tattoo were analysed for elemental contents by inductively coupled plasma mass spectrometry and synchrotron‐based X ‐ray fluorescence ( XRF ) spectroscopy. Results Nickel ( N i) and chromium ( C r) as well as high levels of titanium ( T i) and aluminium were detected in both the skin biopsy and the implants. XRF analyses identified C r( III ), with C r( VI ) being absent. Patch testing gave negative results for N i and C r. However, patch tests with an extract of the implants and metallic T i on the tattooed skin evoked flare‐up of the symptoms. Conclusion The patient's hypersensitivity reaction and its spontaneous remission after removal of the implants indicate that T i, possibly along with some of the other metals detected, could have played a major role in this particular case of tattoo‐related allergy.