Tattoo ink-related cutaneous pseudolymphoma: a rare but significant complication. Case report and review of the literature

Aesthetic Plast Surg. 2014 Apr;38(2):471-8. doi: 10.1007/s00266-014-0287-5. Epub 2014 Feb 26.

Abstract

Background: The demand for decorative tattoos is steadily growing worldwide, and in the US it is estimated that up to 24% of adults has one or more tattoos. Subsequently, the number of tattoo-related complications is increasing. Among these, lymphoproliferative disorders play a minor but important role. The aim of this article is to arouse the awareness of plastic surgeons and dermatologists about this rare but serious complication and to stimulate stricter clinical control of their tattooed patients.

Methods: We report a new case of tattoo-related cutaneous pseudolymphoma (CPL) and perform a review of the last 30 years of literature on the topic in PubMed.

Results: Apart from this new case, only 18 cases of CPL have been reported in PubMed so far. In contrast to the classic knowledge, the T cell was the predominant phenotype in 68% of cases. Red is confirmed to be the most involved ink. Topical and intralesional steroids, laser therapy, and surgery were used for treatment of CPL.

Conclusions: Even if CPL is a very rare and benign complication, we should not forget that in rare cases pseudolymphoma may evolve into a true lymphoma. Diagnosis is still difficult and is based on anamnestic, clinical, and histopathological data. From the review of the literature, the T cell predominance suggests a reclassification of tattoo-induced CPL and there is not a gold standard treatment yet. Finally, once a pseudolymphoma is diagnosed, there must be a long follow-up because of the possibility to transform into a malignancy.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biopsy, Needle
  • Coloring Agents / adverse effects*
  • Dermatologic Surgical Procedures / methods
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Ink*
  • Male
  • Pseudolymphoma / chemically induced*
  • Pseudolymphoma / pathology
  • Pseudolymphoma / surgery
  • Rare Diseases
  • Risk Assessment
  • Skin Diseases / chemically induced*
  • Skin Diseases / pathology
  • Skin Diseases / surgery
  • Tattooing / adverse effects*
  • Treatment Outcome

Substances

  • Coloring Agents