Basal cell carcinoma arising in a tattooed eyebrow

Cutaneous Malignancies in Tattoos, a Case Series of Six Patients

Background: A variety of side effects following the tattooing of the skin were reported over the years. Analytical studies showed that some tattoo inks contain harmful compounds. Methods: We presented six patient cases with cutaneous malignancies in tattooed skin and performed an extensive literature research. Results: Two patients with black ink tattoos that were diagnosed with malignant melanoma raises the number of described cases to 36 patients. One of the patients developed an immunologic reaction limited to the tattoo area after treatment with a targeted immune therapy. In the other patient, the malignancy (malignant melanoma) was fatal. Basal cell carcinoma was seen in four patients with tattoos containing varying ink colors (black, green, red). This increased the number of described patient cases to 18. Although some ink components and their cleavage products have carcinogenic properties, epidemiological evidence for a causative correlation fails. Further epidemiologic studies on tattoos and malignancies, as well as on the appearance of naevi in tattoos, are necessary. Determining the type of mutation might be helpful to separate sun-induced tumors from skin cancers due to other pathogenic mechanisms.

Staged excision of basal cell carcinoma arising from a tattooed eyebrow

Side effects of tattoos can occur due to unexpected body responses. Concerns about the side effects of tattoos are growing concomitantly with the increasing number of tattooed individuals. We report a rare case of basal cell carcinoma (BCC) on a tattooed eyebrow. A 48-year-old woman with no family history or occupational risk of skin cancer had her eyebrows tattooed 6 years prior, and she noticed a black mass on her right eyebrow 1 year before presentation. Staged excision was planned due to the patient’s reluctance regarding the possibility of a wide scar. After the first surgical procedure, a histopathological examination confirmed BCC. Wide excision and primary closure were performed for remnant BCC, and no recurrence was observed. The mechanism of skin neoplasms involving tattoos has not been clearly identified. Unapproved tattoo inks contain carcinogenic substances, and previous case reports indicate that skin neoplasms may differ depending on the tattoo color. Therefore, the carcinogenic effects of these unknown components of tattoo ink might cause skin neoplasms. Accurate component analysis and systematic management of tattoo ink is necessary, and medical practitioners must also pay attention to this possibility because it is easy to overlook tattoos as a causal factor contributing to cancer.

Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence

Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injection-associated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.

[Melanoma within tattoos: Two cases and a systematic literature review]

BACKGROUND

There have been reports of malignant melanoma arising within tattoos. However, there is no clear relationship between tattoos and the development of cutaneous malignancies. We report two new cases of melanoma and provide a review of cases of melanoma reported in the medical literature.

PATIENTS AND METHODS

Case No. 1: a 61-year-old patient consulted following the appearance one year ago of a nodular lesion measuring 4.5×3cm on a blue and red tattoo on his back. Complete excision of the lesion with histological analysis revealed an ulcerated nodular melanoma with a Breslow depth of 7mm. No secondary sites were found. Case No. 2: a 39-year-old patient with a blue tattoo on his left arm consulted following the appearance of a pigmented lesion a few months earlier. Surgical excision was immediately performed, confirming the diagnosis of SSM, with a Breslow depth of 0.9mm. There was no sign of relapse 9 years later.

DISCUSSION

In our systematic review we noted 34 cases of melanoma occurring in tattoos. There was a high male prevalence (90.3%) and a relatively young mean age (45.9 years). Most tattoos were monochrome (71.0%). The average time between tattooing and onset of melanoma was 13.2 years. The most common sites of melanoma were the upper limbs (53.1%) and trunk (34.4%). Mean tumor size was 11.6mm. Histologic examination revealed 2 cases of melanoma in situ, and in 13 cases, the Breslow depth was 1mm or less. In 5 cases, macroscopic or microscopic lymph node metastasis (sentinel lymph node) was found at diagnosis, and in one case, in transit skin metastases were also observed at the time of diagnosis. We discuss the hypothetical pathogenic role of tattoos in melanoma.

Basal Cell Carcinoma Originating in a Tattoo: Case Report and Review of an Uncommon Complication in Tattoo Recipients

Background

The placement of a tattoo is a common event. Basal cell carcinoma arising from a tattoo is rare despite this neoplasm being the most common form of skin cancer.

Objective

We describe a 41-year-old man who developed a basal cell carcinoma in his tattoo and review the literature of basal cell carcinomas originating in a tattoo.

Methods

A literature search using PubMed was performed. The following terms were searched: "basal," "carcinoma," "cell," and "tattoo." The characteristics of individuals with a basal cell carcinoma originating in a tattoo were analyzed and summarized.

Results

A total of 13 patients (6 women and 7 men) with a basal cell carcinoma arising in a tattoo have been reported. The majority of the tumors were located on the head (6 cases, 46.2%) followed by either an upper extremity (4 cases, 30.7%) or the trunk (3 cases, 23.1%). Most of the carcinomas were asymptomatic; however, 2 patients reported pruritus associated with their tumor. Nodular basal cell carcinoma was the most common subtype diagnosed (5 tumors), followed by superficial basal cell carcinoma (2 tumors). One patient had either a pagetoid or a mixed (nodular and sclerosing) histology. The pathological variant was not described for 4 patients.

Conclusions

Basal cell carcinoma arising in a tattoo is a rare occurrence. Although this occurrence may be coincidental, emerging evidence of carcinogenesis associated with tattoo pigment may suggest a causal link. Elucidating this important relationship warrants further investigation.

Malignant Melanoma Arising in Red Tattoo Ink

We report the case of a 33-year-old male who presented with a malignant melanoma on his anterior chest wall. The lesion was only found in the red ink pigment of the tattoo, as were several in-transit dermal metastases. Possible explanations include a pre-existing lesion which was seeded with red ink or the possibility of the red ink causing an inflammatory reaction leading to malignant transformation. This is the first reported case of a melanoma developing in the red ink pigment of a multi-colored tattoo.

Oncologic Surgery to the Ciliary Region

Dermatologic surgery for tumors affecting only the ciliary region is not very common and it can sometimes be difficult to find published descriptions that deal specifically with surgery to this area. However, reconstruction of the ciliary region is very important, not only because this region is necessary to protect the eye, but also because its position and continuity are of great importance in facial expression, aesthetic appearance, and harmony. We present the cases of patients who have undergone oncologic surgery to the eyebrow region in our department in recent years and review the different techniques proposed for reconstruction of this region.