Skin inflammatory (nontumor)
Dermal collagen and elastic tissue alterations, and cutaneous deposits

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 17 October 2018, last major update August 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Tattoo [title]

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Cite this page: Hamodat, M. Tattoo. website. Accessed January 22nd, 2019.
Definition / general
  • Dye injected into dermis is phagocytosized by macrophages, which are permanent
  • Image does fade over time
  • Complications include infections introduced at time of tattooing; cutaneous diseases that localize in tattoos, often in a koebner-type phenomenon; allergic reactions to tattoo pigments and photosensitivity reactions
  • Laser therapy
Microscopic (histologic) description
  • Tattoo pigments are easily visualized in tissue sections
  • After several weeks, they localize around vessels in the upper and mid-dermis in macrophages and fibroblasts
  • Extracellular deposits of pigment are also found between collagen bundles; the pigment is generally refractile, but not doubly refractile
  • No foreign body granulomatous reaction except in presence of other severe reactions
  • Hypersensitivity reactions vary from a diffuse dermal lymphohistiocytic infiltrate with plasma cells and eosinophils, to a lichenoid reaction sometimes with associated epithelial hyperplasia
  • Sarcoidal granulomas, a granuloma annulare-like reaction, vasculitis, pseudolymphomatous patterns and scarring may be present
  • Rare features are a morphea-like reaction, epidermal spongiosis and pseudoepitheliomatous hyperplasia