title: Lichenoid red tattoo reaction: histological and immunological perspectives.
abstract: As tattooing practices increase, delayed-type inflammatory reactions represent an uncommon adverse event to tattoo pigments. Different reaction patterns, such as eczematous, lichenoid, granulomatous and pseudolymphomatous reactions, have been previously reported, especially in association with metals contained in red tattoo pigments. We report a lichenoid papular reaction to an organic red tattoo ink, characterized by an intense mononuclear infiltrate dominated by CD8(+) T cells and CD56(+) lymphocytes and distributed in the superficial dermis around the red pigment and in the epidermis. Cytofluorimetric analysis of the lesional skin infiltrate confirmed the high frequency of cytotoxic CD8(+ )T cells and CD56(+)CD16(-) lymphocytes, most of which release type 1 cytokines. Chemical analysis of the red tattoo pigment confirmed its organic nature and the presence of intermediate reactive compounds. The lichenoid tissue reaction to red organic tattoo pigment showed the prototypical features of a cytotoxic inflammatory response to foreign substances (xenobiotics). The chemically unstable and reactive nature of modern tattoo pigments has to be taken into account by the clinician as well by the tattoo recipients.
authors.affiliation: Institute of Dermatology, Policlinico A. Gemelli University Hospital, Rome.
authors.forename: Simone
authors.initials: S
authors.lastname: Garcovich
authors.forename: Teresa
authors.initials: T
authors.lastname: Carbone
authors.forename: Simona
authors.initials: S
authors.lastname: Avitabile
authors.forename: Francesca
authors.initials: F
authors.lastname: Nasorri
authors.forename: Nadia
authors.initials: N
authors.lastname: Fucci
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavani
mesh_terms: D000328:Adult; D019002:CD56 Antigen; D018414:CD8-Positive T-Lymphocytes; D004396:Coloring Agents / Q000009:adverse effects*; D006801:Humans; D017512:Lichenoid Eruptions / Q000139:chemically induced* / Q000276:immunology* / Q000473:pathology; D008297:Male; D013653:Tattooing / Q000009:adverse effects*
chemical_list: D019002:CD56 Antigen; D004396:Coloring Agents