Ablative laser surgery for allergic tattoo reactions: a retrospective study
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ORIGINAL ARTICLE
Ablative laser surgery for allergic tattoo reactions: a retrospective study S. A. S. van der Bent 1 & Sanne Huisman 1
&
T. Rustemeyer 1 & A. Wolkerstorfer 1
Received: 16 April 2020 / Accepted: 15 October 2020 # The Author(s) 2020
Abstract Patients with allergic tattoo reactions are burdened with itch and have a reduced quality of life. Conservative treatment is often insufficient and little is known about treatment options to remove the responsible allergen. We aimed to address the effectiveness and safety of ablative laser therapy including measurement of patient’s satisfaction, in patients with allergic reactions to tattoos. A retrospective study was conducted including patients with allergic tattoo reactions who were treated with a 10,600 nm ablative CO2 laser, either by full-surface ablation or fractional ablation. Clinical information originated from medical files and a 25-item questionnaire. Sixteen tattoo allergy patients were treated with a CO2 laser between January 2010 and January 2018. Fourteen patients completed the questionnaire. Ten patients were satisfied with laser treatment. On a visual analogue scale, pruritus and burning improved with a median of 5.5 and 4 points in the full surface ablation group and 3 points on both parameters in the fractional ablation group. Despite the relatively small group of patients, our results suggest that CO2 laser ablation improves itching, burning and impact on daily life in tattoo allergy. Keywords Red tattoo . Contact dermatitis . Ablative laser . CO2 laser . Patient-reported outcome
Introduction Tattooing is a worldwide popular form of body art with an overall prevalence in Europe and the USA of approximately 10–20% [1]. Although it is regarded safe, adverse reactions may occur, including allergic reactions. Many dyes are used for tattooing, but the red dye is most frequently associated with allergic reactions [2, 3]. These reactions are chronic and persistent, characterised by itch, burning and pain and can develop months to many years after getting a tattoo. Regardless of size and location of the affected area, allergic reactions can result in a significantly reduced quality of life [4]. Several clinical subtypes can be recognised of which the ‘plaque type’ is most common. Other, less common types are the ‘excessive hyperkeratotic reaction’ or the ‘ulcero-necrotic reaction’ [5, 6]. Thus far, the responsible allergens have not
* Sanne Huisman [email protected] 1
Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, 2205 AZ Amsterdam, The Netherlands
been identified and the exact patho-mechanism remains unknown [7–9]. Treatment of these allergic reactions is difficult, as tattoo pigments are permanently stored in the dermis. Topical or intralesional corticosteroids are indicated as first-line treatment but effects are often temporary and unsatisfactory [10]. Allopurinol was reported to be effective in one patient; however, symptoms recurred after withdrawal
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