Skin nontumor
Dermal collagen and elastic tissue alterations and metabolic disorders
Tattoo
Last author update: 1 August 2011
Last staff update: 3 April 2020
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Tattoo [title]
Table of Contents
Definition / general | Clinical features | Treatment | Microscopic (histologic) descriptionCite this page: Hamodat M. Tattoo. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumortattoo.html. Accessed January 5th, 2025.
Definition / general
- Dye injected into dermis is phagocytosized by macrophages, which are permanent
- Image does fade over time
- Complications include infections introduced at time of tattooing; cutaneous diseases that localize in tattoos, often in a koebner-type phenomenon; allergic reactions to tattoo pigments and photosensitivity reactions
Clinical features
Lymph nodes:
- May cause lymphadenopathy, usually resolves spontaneously
- Pigment initially within keratinocytes, fibroblasts, macrophages and mast cells; later only within dermal fibroblasts surrounded by connective tissue; eventually tattoo ink appears in regional lymph nodes
- Melanoma patients should be questioned regarding history of tattoos, particularly prior to sentinel node treatment (Int Semin Surg Oncol 2005;2:28)
- Histologic confirmation of melanoma in nodes is necessary to avoid unnecessary surgery (Dermatol Surg 1996;22:92)
Treatment
- Laser therapy
Microscopic (histologic) description
- Tattoo pigments are easily visualized in tissue sections
- After several weeks, they localize around vessels in the upper and mid-dermis in macrophages and fibroblasts
- Extracellular deposits of pigment are also found between collagen bundles; the pigment is generally refractile, but not doubly refractile
- No foreign body granulomatous reaction except in presence of other severe reactions
- Hypersensitivity reactions vary from a diffuse dermal lymphohistiocytic infiltrate with plasma cells and eosinophils, to a lichenoid reaction sometimes with associated epithelial hyperplasia
- Sarcoidal granulomas, a granuloma annulare-like reaction, vasculitis, pseudolymphomatous patterns and scarring may be present
- Rare features are a morphea-like reaction, epidermal spongiosis and pseudoepitheliomatous hyperplasia
