Atypical Intraepidermal Melanocytic Proliferation Masked by a Tattoo: Implications for Tattoo Artist

Atypical Intraepidermal Melanocytic Proliferation Masked by a Tattoo: Implications for Tattoo Artists and Public Health Campaigns.

Medium - Industry wide monitoring is recommended.

Cureus. 2018 Jul 13;10(7):e2975. doi: 10.7759/cureus.2975.

The authors present a case of atypical intraepidermal melanocytic proliferation masked by a large tattoo coupled with high resolution cytology images of excised tissue. The authors make the observation that based on their review there are a relatively small number of cases of melanoma in tattoos reported in the medical literature (17) and those cases of melanoma and basal cell carcinoma tended to appear more often on black tattoos in contrast to squamous cell carcinoma, keratoacanthomas, and benign pseudo-epitheliomatous hyperplasia cases in tattoos which seem to have occurred more often in association with red tattoos.

The authors make the compelling argument that although a causal link between tattoos and melanoma has not been established, early detection of melanocytic changes may be masked by tattoos, therefore those people who are in higher risk groups "Individuals with numerous nevi, atypical mole syndrome, or a family history of melanoma" should consider having a dermatological exam prior to undergoing tattooing and those who do have tattoos would should consider "close monitoring of tattoos and regular skin examinations to facilitate the early diagnosis and treatment of developing skin malignancies".

In an article published here on CTshop.com.au in our Educational Articles section;
"Carcinomas in Tattoos a Statistical Anomaly"

We mention that currently there is not a standardised mandatory reporting system for cancers in tattoos which may go some way towards explaining the unexpectedly low incidence of cancers in tattoos relative to the incident rates of cancers in un-tattooed skin.

The authors mention that a large proportion of tattooist (90%) have expressed an interest in undergoing further education in skin conditions, no doubt that this would a positive impact on early detection and referral however it would also require a standardised approach to the provision of education and clearly identified boundaries for the degree of advice to be provided by tattooist to their client base.

Any client who has one of the following;

• Numerous nevi (numerous moles/pigmented skin lesions)

• Atypical mole syndrome (also referred to as dysplastic nevi) - Unusual looking moles (large and irregular), multiple moles on their skin (e.g. 50 or more) and the condition may also run in their family.

• Family history of melanoma

• Unusual skin lesions or active skin condition

Should be advised to seek advice from a dermatologist prior to undergoing tattooing
&
All clients with tattoos should consider undergoing regular skin checks (particularly those with body art that obscures the underlying skin) to aid in early detection of skin changes.

Scientific Report,  moles, nevi, nevus, atypical melanocytic proliferation, early detection, melanoma, public health, tattoo