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Tattoo allergy—diagnosis on a circuitous route?

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Abstract

Background

Decorative tattoos and permanent make-up have been gaining popularity for years. Increasingly, intolerance reactions occur.

Methods

Literature search of PubMed and reference books on diagnostic and treatment options for tattoo complications.

Results

At least one third of persistent intolerance reactions to tattoos are allergic reactions. The diagnostic work-up should include the tattoo ink used and, particularly in cases of scattered eczema, other products applied. Pigments penetrate very poorly into the epidermis and are not available as commercial test preparations. Consequently, patch tests very often show (false) negative results in affected individuals. Allergological individual diagnosis and assessment of clinical relevance are rarely possible as the chemical composition of the culprit tattoo ink is usually unknown.

Discussion

Diagnosis of tattoo allergy is challenging. The IVDK Tattoo Study 2.0 enables the identification of metals and pigments in skin samples, the preparation of individual patch test preparations with pigments, and the investigation of specific T lymphocytes in blood samples. In addition, assessment of the clinical relevance can be improved by exposure data and results of laboratory diagnostics.

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Abbreviations

AIM:

Activation induced marker

BfR:

German Federal Institute for Risk Assessment

C.I.:

Color index

CAS:

Chemical Abstracts Service

DKG:

German Contact Dermatitis Research Group

IVDK:

Information Network of Departments of Dermatology

PAAs:

Primary aromatic amines

PBMCs:

Mononuclear cells of peripheral blood

PPD:

p-Phenylenediamine

REACH:

Registration, Evaluation, Authorization and Restriction of Chemicals

SLS:

Sodium lauryl sulfate

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Funding

The IVDK Tattoo Study 2.0 is partially funded by the German Federal Institute for Risk Assessment under grant number 60-0102-02.P626 from 2023 to 2026.

Author information

Authors and Affiliations

  1. Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Geiststraße 3, 37073, Göttingen, Germany

    Steffen Schubert

  2. Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany

    Carina Wolf &  Uwe Karst

  3. Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment (BfR), Berlin, Germany

    Ines Schreiver &  Katherina Siewert

Authors
  1. Steffen Schubert
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  2. Carina Wolf
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  3. Ines Schreiver
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  4. Katherina Siewert
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  5. Uwe Karst
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Corresponding author

Correspondence to Steffen Schubert.

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Conflict of interest

The Information Network of Departments of Dermatology (IVDK), maintained by the IVDK e. V., of which S. Schubert is an employee, is partly sponsored by tattoo manufacturers and tattoo associations. S. Schubert received lecture fees at educational and informational events for dermatologists and tattoo artists. C. Wolf, I. Schreiver, K. Siewert and U. Karst declare no conflict of interests.

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Schubert, S., Wolf, C., Schreiver, I. et al. Tattoo allergy—diagnosis on a circuitous route?. Allergo J Int 33, 60–66 (2024). https://doi.org/10.1007/s40629-023-00280-7

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  • DOI: https://doi.org/10.1007/s40629-023-00280-7

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