Medical Complications of Tattooing: A Bicentric Retrospective Study

Background and Objectives Tattooing is very popular, but it can cause a variety of medical complications. Detailed knowledge about these complications and accurate diagnostic and therapeutic methods are needed. The aim of this study is to analyse cutaneous complications after tattooing, to describe diagnostic approaches and to elaborate therapeutic methods. Patients and Methods We performed a retrospective systematic analysis of patients with tattoo complications who presented to the Departments of Dermatology at the University Hospitals Zurich and Bern between 2006 and 2020. A total of 58 patients were included and analysed regarding patient characteristics, tattoo characteristics, treatment of the tattoo complication and outcome. Results Frequent tattoo complications were adverse cutaneous inflammatory reactions, including hypersensitivity reactions (87.9%), in a few cases with systemic involvement, followed by development of neoplasms (6.9%; one melanoma, one superficial basal cell carcinoma, one squamous cell carcinoma and one viral acanthopapilloma with atypia) and cutaneous infections (5.2%). Different treatment methods were used depending on the suspected aetiology of the tattoo complication. Conclusions Cutaneous tattoo complications are polymorphous. A thorough work‐up to rule out underlying systemic disease, malignancy, or infection is strongly recommended, especially in persistent, therapy‐resistant cases. In patients with refractory inflammatory tattoo reactions, laser treatment may be a promising therapeutic option.