Today we are going to talk about a lifelong inflammatory process and some of the implications of this inflammatory process for disease. The pathologies we will talk about is the chronic inflammatory response to tattoos. In a recent article published in March 2018 in the Journal of Experimental Medicine titled "Unveiling skin macrophage dynamics explains both tattoo persistence and strenuous removal" Baranska et al explain what happens to tattoo ink when it is injected into the dermis. The pigment injected into the dermis generates an inflammatory response. A specific type of macrophage, known as a melanophage, along with other immune cells, race to engulf the foreign substance, in this case tattoo ink. In other words the ink does not stay in the dermis it is retained inside these macrophages. When the melanophage dies it then bursts, and then another melanophage engulfs the pigment which has been released. The result is an endless cycle of immune response and cell death of macrophages. While some of the pigment laden immune cells stay at the site where the tattoo was placed, others are taken by immune cells to the lymph nodes scattered throughout the body. Thus when you look at a tattoo, you are actually looking at a collection of dying macrophages in the skin. Every 90 days these macrophages die and are replaced by new macrophages. Tattoo associated diseases In order to read the most recent research related to tattoo related diseases click on the links below::
Bacterial endocarditis, aortic regurgitation, and heart failure https://heart.bmj.com/content/85/1/11 https://www.ncbi.nlm.nih.gov/pubmed/18710675 https://www.sciencedirect.com/science/article/pii/S0167527307018761 https://link.springer.com/article/10.1007/s00059-013-3810-6 Systemic sarcoidosis and granulomas https://www.nejm.org/doi/full/10.1056/nejmicm1215331 https://www.sciencedirect.com/science/article/pii/S0926995998001238 Uveitis https://www.nature.com/articles/eye201017 https://onlinelibrary.wiley.com/doi/full/10.1111/aos.12216 https://www.aao.org/editors-choice/seven-cases-of-tattooassociated-uveitis Non-tuberculous mycobacteria https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6133a3.htm https://www.ncbi.nlm.nih.gov/pubmed/23704119 https://www.medscape.com/viewarticle/771466_transcript https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/27993 Inflammatory myopathy and immune deficiency https://www.mdedge.com/edermatologynews/article/168368/mixed-topics/inflammatory-myopathy-following-tattoo-reported https://www.techtimes.com/articles/230653/20180620/woman-suffers-3-years-of-chronic-pain-after-getting-tattoo-heres-what-happened.htm Haemophilus influenza sepsis https://www.consultant360.com/articles/rare-tattoo-complication-haemophilus-influenzae-sepsis-teenager Hepatitis C https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.26245 https://www.sciencedirect.com/science/article/pii/S1201971210024227 https://www.ncbi.nlm.nih.gov/pubmed/23315899 Painful pigmented lymphadenopathy which mimics melanoma, lymphoma or breast cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325237/ https://www.ajemjournal.com/article/S0735-6757(13)00113-7/abstract https://www.ncbi.nlm.nih.gov/pubmed/8556264 Pyoderma gangrenosum https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150710/ https://www.jaad.org/article/S0190-9622(15)00445-4/abstract?code=ymjd-site Psoriasis, discoid lupus erythematosus and lichen planus https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391350/ https://jamanetwork.com/journals/jamadermatology/article-abstract/522265 https://onlinelibrary.wiley.com/doi/abs/10.1002/art.21334 http://www.cmaj.ca/content/185/7/585 Malignant melanoma, basal cell carcinoma, squamous cell carcinoma, dermatofibrosarcoma protuberans, B cell lymphoma and leiomyosarcoma. https://www.ncbi.nlm.nih.gov/pubmed/21818504 https://www.ncbi.nlm.nih.gov/pubmed/18521416 https://www.jprasurg.com/article/0007-1226(83)90103-0/pdf Infection, Allergic Contact Dermatitis and Keloids http://www.cmaj.ca/content/185/7/585 Thousands of adverse effects have been reported in medical journals around the world including India https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519250/ Denmark https://www.karger.com/Article/FullText/452148 Finland https://www.karger.com/Article/FullText/468536 Here is a book dedicated to complications of tattoos https://books.google.com/books?id=r1diDwAAQBAJ&pg=PA85&lpg=PA85&dq=discoid+lupus+erythematosus+tattoos&source=bl&ots=Rql_-b5BUb&sig=eXeVVYkBhWqAon-GqHQSoDAYQZs&hl=en&sa=X&ved=2ahUKEwjkvP_S1IndAhXIqVQKHfpHBTs4FBDoATAHegQIARAB#v=onepage&q=discoid%20lupus%20erythematosus%20tattoos&f=false
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August 2018
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