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van Santen S, van Zuuren EJ, Wolkerstorfer A, van der Bent SA. Delayed Onset Type I Allergic Reaction Following Black Tattoo Removal Using Picosecond Laser. Dermatol Surg 2024; 50:597-598. [PMID: 38477881 PMCID: PMC11136261 DOI: 10.1097/dss.0000000000004127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Affiliation(s)
- Suzanne van Santen
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Esther J. van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, the Netherlands
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2
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Giulbudagian M, Battisini B, Bäumler W, Blass Rico AM, Bocca B, Brungs C, Famele M, Foerster M, Gutsche B, Houben V, Hauri U, Karpienko K, Karst U, Katz LM, Kluger N, Serup J, Schreiver I, Schubert S, van der Bent SAS, Wolf C, Luch A, Laux P. Lessons learned in a decade: Medical-toxicological view of tattooing. J Eur Acad Dermatol Venereol 2024. [PMID: 38709160 DOI: 10.1111/jdv.20072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/15/2024] [Indexed: 05/07/2024]
Abstract
Tattooing has been part of the human culture for thousands of years, yet only in the past decades has it entered the mainstream of the society. With the rise in popularity, tattoos also gained attention among researchers, with the aim to better understand the health risks posed by their application. 'A medical-toxicological view of tattooing'-a work published in The Lancet almost a decade ago, resulted from the international collaboration of various experts in the field. Since then, much understanding has been achieved regarding adverse effects, treatment of complications, as well as their regulation for improving public health. Yet major knowledge gaps remain. This review article results from the Second International Conference on Tattoo Safety hosted by the German Federal Institute for Risk Assessment (BfR) and provides a glimpse from the medical-toxicological perspective, regulatory strategies and advances in the analysis of tattoo inks.
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Affiliation(s)
- Michael Giulbudagian
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Beatrice Battisini
- Department of Environment and Health, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Wolfgang Bäumler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - Ana M Blass Rico
- European Commission, DG Internal Market, Industry, Entrepreneurship and SMEs (GROW), Brussels, Belgium
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Corinna Brungs
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Marco Famele
- National Centre for Chemicals, Cosmetic Products and Consumer's Health Protection - Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Milena Foerster
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Birgit Gutsche
- Karlsruhe Chemical and Veterinary Investigation Authority, Karlsruhe, Germany
| | | | - Urs Hauri
- Kanton Basel-Stadt, Kantonales Laboratorium, Basel, Switzerland
| | - Katarzyna Karpienko
- Department of Metrology and Optoelectronics, Faculty of Electronics, Telecommunication, and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Linda M Katz
- Office of Cosmetics and Colors, United States Food and Drug Administration (FDA), College Park, Maryland, USA
| | - Nicolas Kluger
- Department of Dermatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- "Tattoo Consultation", Department of Dermatology, Bichat - Claude Bernard Hospital, Paris, France
- EADV Tattoo and Body Art Task Force, Lugano, Switzerland
| | - Jørgen Serup
- Department of Dermatology, the Tattoo Clinic, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology - IVDK, Institute at the University Medical Center Göttingen, Göttingen, Germany
| | | | - Carina Wolf
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Peter Laux
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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3
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Pirrera A, Giansanti D. Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review. Bioengineering (Basel) 2024; 11:376. [PMID: 38671797 PMCID: PMC11048663 DOI: 10.3390/bioengineering11040376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
The increased interest in sensing tattoos reflects a shift in wearable technology, emphasizing their flexible, skin-adherent nature. These devices, driven by advancements in nanotechnology and materials science, offer highly sensitive and customizable sensors. The growing body of research in this area indicates a rising curiosity in their design and applications, with potential uses ranging from vital sign monitoring to biomarker detection. Sensing tattoos present a promising avenue in wearable healthcare technology, attracting attention from researchers, clinicians, and technology enthusiasts. The objective of this study is to analyze the development, application, and integration of the sensing tattoos in the health domain. A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome reported 37 studies. Sensing tattoos hold transformative potential in health monitoring and physiological sensing, driven by their focus on affordability, user-friendly design, and versatile sensorization solutions. Despite their promise, ongoing refinement is essential, addressing limitations in adhesion, signal quality, biocompatibility, and regulatory complexities. Identified opportunities, including non-invasive health monitoring, multiplexed detection, and cost-effective fabrication methods, open avenues for personalized healthcare applications. However, bridging gaps in medical device standards, cybersecurity, and regulatory compliance is imperative for seamless integration. A key theme calls for a holistic, user-centric approach, emphasizing interdisciplinary collaboration. Balancing innovation with practicality, prioritizing ethics, and fostering collaboration are crucial for the evolution of these technologies. The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the responsible integration of sensing tattoos into daily life.
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Affiliation(s)
- Antonia Pirrera
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Daniele Giansanti
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
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4
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Bălăceanu-Gurău B, Apostol E, Caraivan M, Ion A, Tatar R, Mihai MM, Popa LG, Gurău CD, Orzan OA. Cutaneous Adverse Reactions Associated with Tattoos and Permanent Makeup Pigments. J Clin Med 2024; 13:503. [PMID: 38256637 PMCID: PMC10816451 DOI: 10.3390/jcm13020503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Tattooing is the procedure of implanting permanent pigment granules and additives into the dermal layer of the skin, serving various purposes such as decoration, medical identification, or accidental markings. There has been a significant rise in the popularity of decorative tattooing as a form of body art among both teenagers and young adults. Thus, the incidence of tattoos is increasing, with expanding applications such as permanent makeup, scar camouflage, nipple-areola, lips, and eyebrows tattooing, and utilization in oncological radiotherapy such as colon marking. However, there have been reported a broad range of adverse reactions linked to tattooing, encompassing allergic reactions, superficial and deep cutaneous infections, autoimmune disorders induced by the Koebner phenomenon, cutaneous tumors, and others. These reactions exhibit different onset times for symptoms, ranging from immediate manifestations after tattoo application to symptoms emerging several years later. Given the limited information on a tattoo's side effects, this review aims to elucidate the clinical spectrum of cutaneous complications of tattoos in different patients. The analysis will investigate both allergic and nonallergic clinical presentations of tattoo-related side effects, microscopic findings from skin biopsies, and therapeutic outcomes. This exploration is essential to improve our understanding of tattoo-related cutaneous complications and associated differential diagnoses and highlight the significance of patient awareness regarding potential risks before getting a tattoo.
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Affiliation(s)
- Beatrice Bălăceanu-Gurău
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Eliza Apostol
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | | | - Ana Ion
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, 010621 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Cristian-Dorin Gurău
- Orthopedics and Traumatology Clinic, Clinical Emergency Hospital, 014451 Bucharest, Romania;
| | - Olguța Anca Orzan
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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5
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Kluger N, Marcaillou M, Sibaud V. Nivolumab-induced poliosis restricted to a tattoo: A coincidental association? Ann Dermatol Venereol 2023; 150:225-226. [PMID: 37271607 DOI: 10.1016/j.annder.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/06/2022] [Accepted: 01/19/2023] [Indexed: 06/06/2023]
Affiliation(s)
- N Kluger
- Department of Dermatology, Allergology and Venereology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; "Tattoo Unit", Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - M Marcaillou
- Department of Oncodermatology, Institut Claudius REGAUD and Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - V Sibaud
- Department of Oncodermatology, Institut Claudius REGAUD and Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France.
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Langbroek GB, Felsbourg J, Wolkerstorfer A, Horbach SE, Kooger LS, van Dieren S, van Not OJ, Pieter van Not H, Souisa R, Ubbink DT, van der Horst CM. Patient-Reported Outcomes of Medical Tattooing for Capillary Malformations. Dermatology 2023; 239:768-781. [PMID: 37442102 PMCID: PMC10614224 DOI: 10.1159/000530609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Patients with capillary malformations (CMs) may undergo medical tattooing (MT) as an alternative to laser therapy. But little is known about treatment results and impact from the patients' perspective. OBJECTIVES In this cross-sectional digital survey study, we evaluated the patient-reported outcomes of MT for CMs. METHODS MT practices were identified via the Dutch Association of Skin Therapists and Google. These practices invited all their CM patients who had undergone MT between January 2011 and September 2021 to participate. Baseline and treatment characteristics, tattooing effectiveness, patient satisfaction with treatment outcomes, and complications were evaluated using a custom-made online survey. Quality of life was assessed with the Dermatology Life Quality Index (DLQI) questionnaire. Factors associated with treatment effectiveness and patient satisfaction were identified via bivariate analysis and ordinal logistic regression analysis. RESULTS Most of the 89 respondents were female (69%). Almost all CMs were located on the face (90%) and mainly (dark) red (74%). Nearly all patients had undergone laser therapy (91%). Median number of tattooing sessions was 5 (IQR: 4.0-8.0). Thirty-seven percent of the patients perceived >75% color reduction. Younger patients were more likely to obtain lower treatment effectiveness (OR 0.44, 95% CI: 0.20-0.97). Most patients (83%) were satisfied with treatment results. Patients with lighter (OR 0.30, 95% CI: 0.13-0.72), non-facial (OR 0.15, 95% CI: 0.03-0.89), and hypertrophic CMs (OR 0.30, 95% CI: 0.11-0.82) were less likely to be satisfied with treatment outcomes. Patients with lighter skin types were more satisfied (OR 2.89, 95% CI: 1.23-6.80). Complications included transient pain (23%), bleeding (3.4%), hypertrophic scarring (1.1%), hypopigmentation (1.1%), and a halo around the tattoo (1.1%). CONCLUSION MT seems a valid alternative treatment in addition to laser therapy for CMs, with mild complications. Most patients are (very) satisfied with treatment results, while color reduction is incomplete. Hence, it seems appropriate to decide together with patients whether or not to use MT as primary treatment or secondary to laser therapy.
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Affiliation(s)
- Ginger Beau Langbroek
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Julia Felsbourg
- Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Dermatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - Sophie E.R. Horbach
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Susan van Dieren
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Olivier J. van Not
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans Pieter van Not
- Plastic Reconstructive and Hand Surgery, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Rinus Souisa
- Medical Tattoo Innovations, Goes, The Netherlands
| | - Dirk T. Ubbink
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Chantal M.A.M. van der Horst
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
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Kurz B, Schreiver I, Siewert K, Haslböck B, Weiß KT, Hannemann J, Berner B, von Eichborn MI, Berneburg M, Bäumler W. Investigation of Adverse Reactions in Tattooed Skin through Histological and Chemical Analysis. Dermatology 2023; 239:782-793. [PMID: 37231944 PMCID: PMC10614264 DOI: 10.1159/000530949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Just as the number of tattooed people has increased in recent years, so has the number of adverse reactions in tattooed skin. Tattoo colourants contain numerous, partly unidentified substances, which have the potential to provoke adverse skin reactions like allergies or granulomatous reactions. Identification of the triggering substances is often difficult or even impossible. METHODS Ten patients with typical adverse reactions in tattooed skin were enrolled in the study. Skin punch biopsies were taken and the paraffin-embedded specimens were analysed by standard haematoxylin and eosin and anti-CD3 stainings. Tattoo colourants provided by patients and punch biopsies of patients were analysed with different chromatography and mass spectrometry methods and X-ray fluorescence. Blood samples of 2 patients were screened for angiotensin-converting enzyme (ACE) and soluble interleukin-2 receptor (sIL-2R). RESULTS Histology showed variable skin reactions such as eosinophilic infiltrate, granulomatous reactions, or pseudolymphoma. CD3+ T lymphocytes dominated the dermal cellular infiltrate. Most patients had adverse skin reactions in red tattoos (n = 7), followed by white tattoos (n = 2). The red tattooed skin areas predominantly contained Pigment Red (P.R.) 170, but also P.R. 266, Pigment Orange (P.O.) 13, P.O. 16, and Pigment Blue (P.B.) 15. The white colourant of 1 patient contained rutile titanium dioxide but also other metals like nickel and chromium and methyl dehydroabietate - known as the main ingredient of colophonium. None of the 2 patients showed increased levels of ACE and sIL-2R related to sarcoidosis. Seven of the study participants showed partial or complete remission after treatment with topical steroids, intralesional steroids, or topical tacrolimus. CONCLUSIONS The combination of the methods presented might be a rational approach to identify the substances that trigger adverse reactions in tattoos. Such an approach might help make tattoo colourants safer in the future if such trigger substances could be omitted.
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Affiliation(s)
- Bernadett Kurz
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Katherina Siewert
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Birgit Haslböck
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Katharina T. Weiß
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Julia Hannemann
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Bianca Berner
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | | | - Mark Berneburg
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Wolfgang Bäumler
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
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8
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Wolf C, Behrens A, Brungs C, Mende ED, Lenz M, Piechutta PC, Roblick C, Karst U. Mobility-resolved broadband dissociation and parallel reaction monitoring for laser desorption/ionization-mass spectrometry - Tattoo pigment identification supported by trapped ion mobility spectrometry. Anal Chim Acta 2023; 1242:340796. [PMID: 36657890 DOI: 10.1016/j.aca.2023.340796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/04/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
In this work, trapped ion mobility spectrometry (TIMS) was introduced to facilitate tandem mass spectrometry (MS2) experiments for laser desorption/ionization-mass spectrometry (LDI-MS) as mobility-resolved fragmentation. The mobility separation of desorbed ions was followed by subsequent fragmentation using data-independent broadband collision-induced dissociation (bbCID) or targeted fragmentation through a prototypic version of parallel reaction monitoring-parallel accumulation serial fragmentation (prm-PASEF) for LDI. Both mobility-resolved fragmentation options, TIMS-bbCID and prm-PASEF, were applied to LDI point measurements to identify organic pigments in tattoo inks. Furthermore, the prototypic prm-PASEF algorithm was used in imaging applications to increase confidence in annotating organic tattoo pigments in skin samples with adverse reactions. Due to less complex spectra in matrix-free LDI, both fragmentation methods yielded fast and reliable MS2 identification workflows. TIMS-bbCID was especially beneficial for the rapid acquisition of multiple fragment spectra. For the targeted prm-PASEF approach, analytes' mobilities needed to be collected prior to simplified fragmentation. Therefore, a reference list for 14 pigments was created. The possible number of experiments per thin section and the associated savings in analysis time compared to conventional MS2 were particularly suitable for the imaging application. Furthermore, the mobility dimension enabled a new orthogonal identification parameter, increasing the annotation confidence of tattoo pigments through compound specific mobilities.
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Affiliation(s)
- Carina Wolf
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Arne Behrens
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany; Bruker Daltonics GmbH & Co. KG, Fahrenheitstraße 4, 28359, Bremen, Germany
| | - Corinna Brungs
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Elias D Mende
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Madina Lenz
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Paul C Piechutta
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Christoph Roblick
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149, Münster, Germany.
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9
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Schubert S, Kluger N, Schreiver I. Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997-2022. Contact Dermatitis 2023; 88:331-350. [PMID: 36772861 DOI: 10.1111/cod.14291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
We outline constituents of tattoo and permanent make-up ink with regard to inflammatory tattoo reactions and population-based confounders. The comprehensive review of patch-tested tattoo patients between 1997 and 2022 shows that tattoo allergy cannot be reliably diagnosed via patch testing with today's knowledge. Weak penetration and slow haptenization of pigments, unavailability of pigments as test allergens and a lack of knowledge concerning relevant epitopes hamper the diagnosis of tattoo allergy. Patch testing p-phenylenediamine and disperse (textile) dyes is not able to close this gap. Sensitization to metals was associated with all types of tattoo complications, although often not clinically relevant for the tattoo reaction. Binders and industrial biocides are frequently missing on ink declarations and should be patch tested. The pigment carbon black (C.I. 77266) is no skin sensitizer. Patch tests with culprit inks were usually positive with cheap ink products for non-professional use or with professionally used inks in patients with eczematous reactions characterized by papules and infiltration. Tape stripping before patch testing and patch test readings on Day 8 or 10 may improve the diagnostic quality. The meaningfulness of the categorical EU-wide ban of Pigment Green 7 and Pigment Blue 15:3 is not substantiated by the presented data.
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Affiliation(s)
- Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Nicolas Kluger
- Department of Dermatology, 'Tattoo' Consultation, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Dermatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Ines Schreiver
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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10
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Nie S, Li K, Gao C, Yin N, Chen Z, Wu Z. Eyebrow tattoo-associated sarcoidosis: A case report. Front Med (Lausanne) 2022; 9:1009135. [DOI: 10.3389/fmed.2022.1009135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
Cutaneous sarcoidosis can manifest after doing a permanent makeup (PMU), such as tattooed eyebrows. A 41-year-old Chinese woman, with a tattoo in the eyebrows, developed yellow–brown plaques in her eyebrows for several months. A dermatopathological examination revealed non-caseating granulomas consistent with cutaneous sarcoidosis. For months, topical corticosteroids were applied, which showed little effect. Furthermore, a physical evaluation of the patient revealed no apparent involvement of other body organs except bilateral hilar lymphadenopathy with few diffuse reticulonodular opacities. On the basis of fully informed consent, the patient agreed to a 6-month initial follow-up to avoid unnecessary PMU.
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11
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Szulia A, Antoszewski B, Zawadzki T, Kasielska-Trojan A. When Body Art Goes Awry-Severe Systemic Allergic Reaction to Red Ink Tattoo Requiring Surgical Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10741. [PMID: 36078458 PMCID: PMC9517851 DOI: 10.3390/ijerph191710741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
The aim of this report is to present a case of a patient who developed unusual systemic hypersensitivity reaction to a red-pigmented tattoo and to discuss diagnostic difficulties in case of systemic reactions to tattoo ink. The patient reported erythroderma on his arms and chest accompanied by plaque elevation of red parts of his most recently performed forearm tattoo as his primary symptoms. His health condition entailed a prolonged topical and intravenous immunosuppressive therapy, which proved ineffective. Over a year after emergence of initial symptoms, he presented to the Plastic Surgery Clinic with generalized erythroderma, systemic lymphadenopathy, elevation and granuloma formation in red tattoos on his forearm and complaints of fatigue and inability to participate fully in work-related and social activities. The patient underwent six staged excisions with direct closures, flap plasties and full-thickness skin grafts. Following completion of each surgical resection, the patient's symptoms gradually subsided. We find this case illustrative of a clinical challenge that delayed hypersensitivity reactions to red tattoos may pose. Furthermore, we provide insights on management of hypersensitivity reactions. This report underlines the importance of social awareness of and public health approach to tattoo complications as key to successful prevention, identification and treatment of adverse reactions to tattoos.
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Affiliation(s)
- Agata Szulia
- The Military Medical Faculty, Medical University of Lodz, 90-419 Lodz, Poland
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Tomasz Zawadzki
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
| | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University of Lodz, Kopcinskiego 22, 90-153 Lodz, Poland
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Devcic J, Dussol M, Collin-Faure V, Pérard J, Fenel D, Schoehn G, Carrière M, Rabilloud T, Dalzon B. Immediate and Sustained Effects of Cobalt and Zinc-Containing Pigments on Macrophages. Front Immunol 2022; 13:865239. [PMID: 35928812 PMCID: PMC9343594 DOI: 10.3389/fimmu.2022.865239] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Pigments are among the oldest nanoparticulate products known to mankind, and their use in tattoos is also very old. Nowadays, 25% of American people aged 18 to 50 are tattooed, which poses the question of the delayed effects of tattoos. In this article, we investigated three cobalt [Pigment Violet 14 (purple color)] or cobalt alloy pigments [Pigment Blue 28 (blue color), Pigment Green 14 (green color)], and one zinc pigment [Pigment White 4 (white color)] which constitute a wide range of colors found in tattoos. These pigments contain microparticles and a significant proportion of submicroparticles or nanoparticles (in either aggregate or free form). Because of the key role of macrophages in the scavenging of particulate materials, we tested the effects of cobalt- and zinc-based pigments on the J774A.1 macrophage cell line. In order to detect delayed effects, we compared two exposure schemes: acute exposure for 24 hours and an exposure for 24 hours followed by a 3-day post-exposure recovery period. The conjunction of these two schemes allowed for the investigation of the delayed or sustained effects of pigments. All pigments induced functional effects on macrophages, most of which were pigment-dependent. For example, Pigment Green 19, Pigment Blue 28, and Pigment White 4 showed a delayed alteration of the phagocytic capacity of cells. Moreover, all the pigments tested induced a slight but significant increase in tumor necrosis factor secretion. This effect, however, was transitory. Conversely, only Pigment Blue 28 induced both a short and sustained increase in interleukin 6 secretion. Results showed that in response to bacterial stimuli (LPS), the secretion of tumor necrosis factor and interleukin 6 declined after exposure to pigments followed by a recovery period. For chemoattractant cytokines (MCP-1 or MIP-1α), delayed effects were observed with a secretion decreased in presence of Pigment Blue 28 and Pigment violet 14, both with or without LPS stimuli. The pigments also induced persisting changes in some important macrophage membrane markers such as CD11b, an integrin contributing to cell adhesion and immunological tolerance. In conclusion, the pigments induced functional disorders in macrophages, which, in some cases, persist long after exposure, even at non-toxic doses.
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Affiliation(s)
- Julie Devcic
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Manon Dussol
- Université Grenoble-Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Recherche Interdisciplinaire de Grenoble (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE), Systèmes Moléculaires et nanoMatériaux pour l’Energie et la Santé (SyMMES), Chemistry Interface Biology for the Environment, Health and Toxicology (CIBEST), Grenoble, France
| | - Véronique Collin-Faure
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Julien Pérard
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
| | - Daphna Fenel
- Univ. Grenoble Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Biologie Structurale (IBS), Grenoble, France
| | - Guy Schoehn
- Univ. Grenoble Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Biologie Structurale (IBS), Grenoble, France
| | - Marie Carrière
- Université Grenoble-Alpes, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Centre National de la recherche Scientifique (CNRS), Institut de Recherche Interdisciplinaire de Grenoble (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE), Systèmes Moléculaires et nanoMatériaux pour l’Energie et la Santé (SyMMES), Chemistry Interface Biology for the Environment, Health and Toxicology (CIBEST), Grenoble, France
| | - Thierry Rabilloud
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
- *Correspondence: Thierry Rabilloud, ; Bastien Dalzon,
| | - Bastien Dalzon
- Chemistry and Biology of Metals, Université Grenoble Alpes, Centre National de la recherche Scientifique (CNRS) UMR5249, Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Institut de Recherche Interdisciplinaire de Grenoble, (IRIG)-Département des Interfaces pour l’Energie, la Santé et l’Environnement (DIESE)-Laboratoire de Chimie et Biologie des Métaux (LCBM)- Équipe Protéomique pour la Microbiologie, l'Immunologie et la Toxicologie (ProMIT), Grenoble, France
- *Correspondence: Thierry Rabilloud, ; Bastien Dalzon,
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13
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Kluger N, Descamps V. Efficacy of low‐dose methotrexate in a short‐regimen for granulomatous sarcoid‐like reaction on permanent make‐up during COVID‐19 infection. J Eur Acad Dermatol Venereol 2022; 36:e741-e742. [PMID: 35604051 PMCID: PMC9348066 DOI: 10.1111/jdv.18252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Nicolas Kluger
- « Tattoo consultation », Department of Dermatology, Bichat‐Claude Bernard Hospital, Assistance Publique‐Hôpitaux de Paris Paris France
- Department of Dermatology, Allergology, and Venereology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Vincent Descamps
- « Tattoo consultation », Department of Dermatology, Bichat‐Claude Bernard Hospital, Assistance Publique‐Hôpitaux de Paris Paris France
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14
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Brungs C, Schmid R, Wolf C, Berg T, Korf A, Heuckeroth S, Hayen H, van der Bent S, Maijer K, Rustemeyer T, Karst U. Tattoo Pigment Identification in Inks and Skin Biopsies of Adverse Reactions by Complementary Elemental and Molecular Bioimaging with Mass Spectral Library Matching. Anal Chem 2022; 94:3581-3589. [PMID: 35179876 DOI: 10.1021/acs.analchem.1c04922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Tattooing has become increasingly popular throughout society. Despite the recognized issue of adverse reactions in tattoos, regulations remain challenging with limited data available and a missing positive list. The diverse chemical properties of mostly insoluble inorganic and organic pigments pose an outstanding analytical challenge, which typically requires extensive sample preparation. Here, we present a multimodal bioimaging approach combining micro X-ray fluorescence (μXRF) and laser desorption ionization-mass spectrometry (LDI-MS) to detect the elemental and molecular composition in the same sample. The pigment structures directly absorb the laser energy, eliminating the need for matrix application. A computational data processing workflow clusters spatially resolved LDI-MS scans to merge redundant information into consensus spectra, which are then matched against new open mass spectral libraries of tattoo pigments. When applied to 13 tattoo inks and 68 skin samples from skin biopsies in adverse tattoo reactions, characteristic signal patterns of isotopes, ion adducts, and in-source fragments in LDI-MS1 scans yielded confident compound annotations across various pigment classes. Combined with μXRF, pigment annotations were achieved for all skin samples with 14 unique structures and 2 inorganic pigments, emphasizing the applicability to larger studies. The tattoo-specific spectral libraries and further information are available on the tattoo-analysis.github.io website.
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Affiliation(s)
- Corinna Brungs
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Robin Schmid
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Carina Wolf
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Tanja Berg
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Ansgar Korf
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Steffen Heuckeroth
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Heiko Hayen
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
| | - Sebastiaan van der Bent
- Tattoo Clinic (Tattoo Poli), Department of Dermatology, Alrijne Hospital, Houtlaan 55, 2334 CK Leiden, The Netherlands
| | - Karen Maijer
- Tattoo Clinic (Tattoo Poli), Department of Dermatology, Alrijne Hospital, Houtlaan 55, 2334 CK Leiden, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 30, 48149 Münster, Germany
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15
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van der Bent SA, van Doorn MB. Successful treatment of a refractory allergic reaction to a red tattoo of the lips with methotrexate and Q-switched Nd-Yag laser. JAAD Case Rep 2022; 21:109-111. [PMID: 35198714 PMCID: PMC8850553 DOI: 10.1016/j.jdcr.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sebastiaan A.S. van der Bent
- Tattoo Clinic (Tattoo poli), Department of Dermatology, Alrijne Hospital, Leiden, The Netherlands
- Correspondence to: Sebastiaan A. S. van der Bent, MD, PhD, Tattoo poli, Department of Dermatology, Alrijne Ziekenhuis, Houtlaan 55, 2334 CK, Leiden, The Netherlands.
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16
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Cunningham ET, Dunn JP, Smit DP, Zierhut M. Tattoo-Associated Uveitis. Ocul Immunol Inflamm 2021; 29:835-837. [PMID: 34955075 DOI: 10.1080/09273948.2021.2006517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.,The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA.,The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
| | - James P Dunn
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA
| | - Derrick P Smit
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Manfred Zierhut
- Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany
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