Unusual complication of a tattoo in an immuno-suppressed patient

Unusual complication of a tattoo in an immunosuppressed patient.

Medium - Industry wide monitoring is recommended.

BMJ Case Reports 18 June 2018; doi:10.1136.

The authors present an unusual case of a 31 year old woman who had been on immunosuppressive therapy following a lung transplant in 2009, the patient underwent tattooing on her right leg several years previously without any adverse affects. However the patient decided to have a second tattoo on her left leg (by an unregulated parlour) and immediately experienced mild skin irritation after tattooing and 9 days later developed pain in her knee and thigh which required analgesics and lasted for 10 months before being referred to a Rheumatology clinic, a biopsy subsequently revealed that the patient had inflammatory myopathy (chronic inflammation of the muscle).

The treating physicians concluded that "While we acknowledge that there is no evidence to definitely prove the causative effect, the timing of onset and the location of the symptoms correlated well with the tattoo application and there were no other identifiable factors to cause the pathology".

Medical specialists play an important role in utilising their empirical knowledge to assess the likelihood of causative connections with disease processes in instances where conclusive medical evidence is not yet available. In this particular case the authors are drawing attention to a possible connection between the tattoo and subsequent development of inflammatory myopathy stating that "In this case, the tattoo application by an unregulated parlour, combined with the patient’s immune suppression could have resulted in the adverse reaction". The authors also mention that the causative mechanism may be unclear "but it is well known that the type of ink or colourant used in tattoos can cause a reaction".

It is advisable for clients who are receiving immunosuppressive therapy or are immunocompromised to seek medical opinion prior to undergoing tattooing.

Scientific Report, myopathy, body art tattoo, unregulated, immunocompromised, immunosuppression