Case of Keratoacanthoma Within Red Tattoo Dye
A fascinating case has been reported in the November 2007 Journal of Cutaneous Pathology. French dermatologists at the University of Montpellier have reported a case of Keratoacanthoma (KA), a common keratinizing squamous cell neoplasm of unknown origin characterized by rapid growth and spontaneous involution, apparently brought on as a complication of red tattoo dye.
A 41 year old woman came to the department with no history of medical problems (other than hereditary spider veins) and presented a growing nodule confined to the red part of a tattoo on the scapula. According to the their report:
Histology showed a keratin-filled cuplike crater with an epithelial proliferation (hyperkeratosis, parakeratosis, no keratinocyte atypia). An inflammatory infiltrate in the dermis composed of lymphocytes and histiocytes intermixed with red ink-related exogenous pigments was noted. Lack of papillomatosis and viral inclusions ruled out the diagnosis of viral wart, absence of granulomatous reaction ruled out deep fungal or mycobacterial infection and lack of cytological atypia and frank architectural abnormalities did not favour a squamous cell carcinoma.
As a result of this case, the report concludes that KA should be included in the list of cutaneous complications related to tattooing. The diagnosis of such complications, however, may be challenging as differential diagnoses include pseudoepitheliomatous hyperplasia and squamous cell carcinoma. The report urges removal of the entire area, thorough histological examination and careful follow up as mandatory.
Does anyone have any experience with such a case? Or complications arising from red dye?
