Piercings in medical students and their effects on the skin

Health risks for body pierced community: a systematic review

OBJECTIVE

Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions.

STUDY DESIGN

This is a systematic review.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools.

RESULTS

A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported.

CONCLUSIONS

Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.

Colonization of Candida After the Placement of a Tongue Piercing, a Case Report

The practice of piercing the body’s different areas is a commonly observed form of body modification. It implies puncturing the skin tissue resulted in an opening, in which specific jewellery or an intradermal implant could be inserted. The tongue piercing is a highly popular form of this practice, but can be followed by multiple acute and chronic complications, such as bacterial and fungal infections. Our case describes the clinical situation of a 25 year old immunocompetent woman, who sought medical help after observing tissue abnormalities, following a newly inserted tongue piercing. We identified a correctly and professionally placed tongue jewellery associated with all clinical hallmarks of oral Candidiasis. Our aim was to microbiologically identify and treat the present yeast colonies.

[Second ear piercing for aesthetic purposes and appearance of pathological scars in negroids: About 172 observations in an endemic area of keloids]

This is a transverse and retrospective descriptive study carried out on a quantitative and qualitative component on pathological scars after a second ear piercing for aesthetic purposes in a Negroid female population from an endemic area of keloids. For a period of 10 years (from January 1, 2010 to December 31, 2019), we observed 172 patients with pathological ear scars after a second piercing for aesthetic purposes including 65.7% of female students and 22.1% of students. Clinically, we had 143 (83.1%) patients with keloids and 29 (16.9%) with hypertrophic scars. The average age of the second piercing was 22.62 years; 98 (57%) patients had single lesions on the pierced ear and 74 (43%) multiple lesions; 168 (97.7%) had no family history of pathological scars. Our patients from an endemic area of keloids did not develop pathological scars during the first piercing but all develop pathological scars after the second piercing. Several risk factors could be accused: heredity, environment, race, age, gender, wearing of poor-quality jewelry, infection, disruption of the healing process caused by the first piercing, mechanical tension caused by the new ornamental object. However, none of these assumptions has been verified. In the meantime, we do not recommend that at risk negroid subjects, originating from areas with high endemicity of keloids, a second ear piercing for aesthetic purposes.

Microdermal Implants Show No Effect on Surrounding Tissue During Surgery With Electrocautery

BACKGROUND

Microdermal implants are an increasingly popular form of body jewelry. The potential for electrical conduction burn at the site of metal jewelry left in situ during electrosurgery has prompted surgical societies to recommend routine removal before surgery. To date, however, there is a lack of evidence to support this practice. We assessed in vivo thermal effect and tissue damage around implants during and after electrocautery.

MATERIALS AND METHODS

Stainless steel microdermal anchors were surgically implanted into four swine. After allowing for initial healing, negative controls were excised and evaluated. An electrocautery grounding pad was placed 2 cm caudal to the implant. Continuous electrocautery (coagulation/30 W) for 30 s was applied to the skin 2 cm cranial to the implant. Surface skin temperature was recorded during electrocautery using thermal imaging. Tissue damage was assessed by gross examination and histologic evaluation. The same procedure was then performed to the contralateral nonimplanted side as a sham control.

RESULTS

Electrocoagulation raised skin temperature around the electrocautery tip 27.7°C (T_max 64.8°C). Skin temperature around the dermal implant rose 1.58°C (T_max 38.6°C) compared with 2.03°C (T_max 39.2°C) in the nonimplanted control skin (P = 0.627). Skin temperatures at implanted and control sites showed no statistical difference at any recorded time interval. Histologic review of excised tissue samples showed no evidence of thermal injury.

CONCLUSIONS

Metallic implants appear to have no effect on skin temperature during the use of electrocautery even when in close proximity to both the electrocautery pen and return pad. Aggressive steps to remove microdermal implants before surgery may be unnecessary.

[Pseudomonas aeruginosa in post-piercing perichondritis: Two case reports]

The frequency of body piercing has increased in France over the past few years, particularly among teenagers. Piercing can be performed at different sites on the body, especially in the cartilage of the ears. We relate two cases of Pseudomonas aeruginosa chondritis. A 10-year retrospective study at the Marseille University Hospital found no additional pediatric cases. These infectious complications can sometimes be necrotizing. It is therefore important to inform the medical staff on the hygiene measures that need to be respected and the patients on the treatment to follow after the piercing as well as the signs to watch for, possibly indicating chondritis. The esthetic consequences depend on early diagnosis.

Adolescent and Young Adult Tattooing, Piercing, and Scarification

Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.

Use of Safety Pin on Garments in Pregnancy: A Belief and Cultural Practice with Potential Harmful Effect

Background

Culture has been known to influence practices and beliefs of people world over. Several cultural practices have been noted among pregnant women who were passed from one generation to the next with its potential harmful and beneficial effect. The use of safety pin in is one of such cultural practices that are widely practiced by many pregnant Nigerian women.

Objective

We sought to gain a deeper understanding of the source of knowledge and motivation behind the use of safety pin on garments during pregnancy as well as explore potential harmful side effects of this cultural practice.

Methodology

A total of 419 pregnant women completed questionnaires for a hospital-based cross-sectional study. Safety pin knowledge and motivation for use on garments were assessed using a pre-tested 16 item questionnaire. Consenting women either completed a self-administered structured questionnaire or utilized the help of trained research assistants. Chi-square tests were used to assess relationships between safety pin use on garments and predictor variables. Analysis was done with Statistical Package for Social Sciences version 17.

Results

Of 419 participants, over half (n = 227) reported safety pin use on garments in pregnancy. About two-thirds (n = 177) of women who use safety pin reported older female relatives as their source of information. The mean age of the participants was 29.1 ± 5.74 (range 16–45 years). Traditional religion worshippers were more likely (81.2%) and Christians were least likely to use safety pin (50.7%) during pregnancy. Pregnant women with a tertiary education (50.4%) were least likely to use safety pin compared with women with no or less than a tertiary level of education. Protection of pregnancy against demons/witchcrafts was the reason given by 129 (56.8%) of participants using safety pin in pregnancy.

Conclusion

The use of safety pin on garments during pregnancy is a common cultural practice in southwest Nigeria. Our findings also suggest that religion and education are important determinants of safety pin use. Although our study did not find a statistically significant difference in safety pin prick incidents among safety pin users, it remains a potential source of harm. Thus, there is a need to establish community and hospital based strategies that address potential cultural harmful practices while promoting culturally appropriate healthcare services.