Skin nontumor

Dermal collagen and elastic tissue alterations, and cutaneous deposits


Last author update: 1 August 2011
Last staff update: 3 April 2020

Copyright: 2002-2023,, Inc.

PubMed Search: Tattoo [title]

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Tattoo. website. Accessed November 29th, 2023.
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
Clinical features
Lymph nodes:
  • May cause lymphadenopathy, usually resolves spontaneously
  • Pigment initially within keratinocytes, fibroblasts, macrophages and mast cells; later only within dermal fibroblasts surrounded by connective tissue; eventually tattoo ink appears in regional lymph nodes
  • Melanoma patients should be questioned regarding history of tattoos, particularly prior to sentinel node treatment (Int Semin Surg Oncol 2005;2:28)
  • Histologic confirmation of melanoma in nodes is necessary to avoid unnecessary surgery (Dermatol Surg 1996;22:92)
  • 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
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