Modern tattoos cause high concentrations of hazardous pigments in skin.

BACKGROUND: Modern tattoo colourants frequently consist of azo pigments that not only contain multiple impurities but also are originally produced for car paint and the dyeing of consumer goods. OBJECTIVE: In order to be able to assess the health risk of tattoos, it is important to determine the pigment concentration in human skin. METHODS: We tattooed excised pigskin and human skin with a common tattoo pigment (Pigment Red 22) under various conditions. After tattooing, we quantitatively extracted the pigment in order to determine the pigment concentration in skin. RESULTS: The concentration of pigments ranged from about 0.60 to 9.42 mg/cm(2) of tattooed skin (mean value 2.53 mg/cm(2)) depending upon the size of the pigment crystals, the pigment concentration applied to the skin surface, and the respective procedure of tattooing. CONCLUSION: In conclusion, high concentrations of colourants are injected into the skin during tattooing and based upon this quantification, a risk assessment of tattooing ought to be carried out.

Aquatic dermatoses.

Despite the fascination of the aquatic world, it can be associated with some medical risks. Natural bodies of water, swimming pools and aquariums contain many living organisms. Some of these aquatic species may cause traumatic or toxic skin reactions after contact as well as life-threatening systemic reactions. Most frequently, the injuries include poisonous bites and stings by coelenter-ates, worms,stinging fish,mollusks and echinoderms or skin infections. A basic knowledge regarding the flora and fauna that populate the aquatic world can help to avoid contact with such organisms,or if it happens,to promptly initiate appropriate therapy.

Azo pigments and a basal cell carcinoma at the thumb.

Basal cell carcinoma is the most common malignant neoplasm of the skin, whereas the localization at the nail unit is very rare. We report the case of a 58-year-old patient with a periungual basal cell carcinoma at the thumb. The specific feature of the reported case is the frequent exposure to fishing baits that the patient had stained with an unknown colorant. The use of chromatography, mass spectrometry and infrared spectroscopy revealed the colorant as the azo pigment Solvent Red 8. Solvent Red 8 is a widespread synthetic azo pigment that is applied to stain consumer products. Compounds such as Solvent Red 8 can be cleaved to carcinogenic amines under, for example, light exposure, in particular after incorporation into the human body. As a result of the frequent skin contact to this azo pigment, this hazard compound might have induced the basal cell carcinoma in our patient.

Granulomatous jellyfish dermatitis.

The induction of a granulomatous inflammation by jellyfish toxins is rare. More typically, acute toxic and urticarial reactions are seen. An 11-year-old boy developed a striated urticarial erythema on the left cheek after contact with a gelatinous mass while swimming in the sea in Croatia. After initial erosion, a striated induration developed in the area of contact. Histological examination revealed a granulomatous inflammation with some eosinophils. While topical steroid-based antiinflammatory and antibacterial therapy over several weeks was not effective, topical therapy with tacrolimus 0.1% for two two-week treatment periods led to healing of the skin changes with a slight scar. There was no clinical recurrence after 5 month of follow-up.

Establishment of an extraction method for the recovery of tattoo pigments from human skin using HPLC diode array detector technology.

Tattooing is a widespread process of puncturing pigments into skin, whereas the resulting concentration inside the skin remains unknown. Many tattoo colorants are organic pigments, such as azo pigments, manufactured for other uses. To remove tattoos from skin, laser pulses at very high intensities are applied to the skin to destroy the tattoo pigments. Recent investigations have shown that several azo compounds are cleaved by laser light leading to potentially toxic or carcinogenic compounds. To assess the risk of tattooing and laser treatment of tattoos, the concentration of the pigments and their decomposition products in the skin must be determined. Therefore, an extraction method was established to determine the concentration of tattoo pigments and decomposition products quantitatively. The extraction of two widely used azo compounds, Pigment Red 22 and Pigment Red 9, and their laser-induced decomposition products, 2-methyl-5-nitroaniline, 4-nitrotoluene, 2,5-dichloraniline, and 1,4-dichlorobenzene, was accomplished using recovery experiments and HPLC-DAD technology. Despite the poor solubility of the pigments, a nearly complete recovery from aqueous suspension (> 92%) or lysed skin (> 94%) was achieved. The decomposition products were extracted from aqueous suspension or skin showing a recovery of up to 100%, except for the very volatile 1,4-DCB.

Neodymium-YAG Laser for hemangiomas and vascular malformations -- long term results.

BACKGROUND: Hemangiomas and vascular malformations are the most common vascular lesions of infancy. Different lasers can be used for treatment. Nd:YAG laser photocoagulation is particularly effective because of its deep penetration into tissue. PATIENTS AND METHODS: Thirty-one patients, aged from three months to 18 years, with voluminous hemangiomas and venous malformations were treated with a cw-neodymium:YAG laser. The quartz fibre was used in percutaneous and intralesional technique. Long-term follow-up data were acquired by clinical control or a patient questionnaire for a maximal period of eight years. Twenty patients could be evaluated. RESULTS: In the group with hemangiomas (n = 15), three cases showed nearly complete remission (> 90 %), ten cases had a partial reduction in size (50 - 90 %), in one case there was stable disease and in one case tumor growth. In the group with venous malformations (n = 5) two cases showed an excellent response (> 90 %), one case a moderate response (25 - 50 %) and in two cases there was no improvement. Adverse effects included scars (40 %), hyper- and hypopigmentation (23 %), mild atrophy (20 %) and a wrinkled texture (17 %). After maximal reduction in size, 30 % of the patients were not satisfied with the laser treatment outcome and elected surgical excision of the residual lesion. CONCLUSIONS: The neodymium:yttrium aluminium garnet (Nd:YAG) laser with percutaneous or intralesional application technique is a valuable tool for selected patients with hemangiomas and venous malformations.

Tattoo pigments are cleaved by laser light-the chemical analysis in vitro provide evidence for hazardous compounds.

In the western world, more than 80 million people decorate their skin with tattoos. Tattoo colorants are injected into the skin, like medical drugs. Most tattoo colorants are industrial pigments, and chemical industries have never produced them for human use but only to stain consumer goods. Up to 10% of tattooed people request removal of their tattoos because of an improved self-image or social stigmatization. In contrast to tattooing, physicians usually perform the tattoo removal. For that purpose laser light at very high intensities irradiates the skin to destroy the tattoo pigments. Based on a recent analysis of tattoo pigments, two widely used azo compounds were irradiated in suspension with laser and subsequently analyzed by using quantitative high-performance liquid chromatography and mass spectrometry. The high laser intensities cleaved the azo compounds, leading to an increase of decomposition products such as 2-methyl-5-nitroaniline, 2-5-dichloraniline and 4-nitro-toluene, which are toxic or even carcinogenic compounds. Moreover, the results of the chemical analysis show that the tattoo colorants already contain such compounds before laser irradiation. Because of a high number of patients undergoing laser treatment of tattoos and based on the results of our findings in vitro, it is an important goal to perform a risk assessment in humans regarding laser-induced decomposition products.