title: [Tattooing agents and adverse reactions].
abstract: BACKGROUND
  Tattoos are regarded as body jewelry and have become widespread in all parts of society. Despite introduction of the tattooing agents' regulation (Tätowiermittelverordnung) in Germany in 2009, consumer protection is incomplete.
  
  
  OBJECTIVE
  Prevalence of tattoos and their legal basis, ingredients of tattooing agents, clinical findings of adverse reactions, pathogenesis and therapy.
  
  
  METHODS
  The work is based on a selective literature search in PubMed and on the clinical experience of the authors.
  
  
  RESULTS
  Adverse reactions by tattooing are a particular problem, because the causing substances are not biodegradable within the tissue. In addition to an agonizing pruritus, the clinical picture is characterized by erythematous plaques. Histopathology reveals different patterns of inflammation, including pseudolymphomatous reactions. Treatment is problematic. In many cases, extensive surgical excision is necessary, which is associated with cosmetic consequences.
  
  
  CONCLUSIONS
  A regulation to assess the safety of tattooing does not exist.
authors.affiliation: Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland. gunnar.wagner@klinikum-bremerhaven.de.
authors.forename: G
authors.initials: G
authors.lastname: Wagner
authors.affiliation: Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Meyer
authors.affiliation: Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland.
authors.forename: M M
authors.initials: MM
authors.lastname: Sachse
mesh_terms: D004396:Coloring Agents / Q000506:poisoning*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D038622:Internationality; D015995:Prevalence; D012307:Risk Factors; D013653:Tattooing / Q000009:adverse effects* / Q000706:statistics & numerical data*
chemical_list: D004396:Coloring Agents
keywords: Excision; Inflammation; Plaques; Pruritus; Tattoos