LAUSR

Tattooing is an ancient form of body art which appeared many thousand years ago. However, it is nowadays when it is evolving into a very common fashion practice, with a usage ranging from 5 to 40% in adults. The tattoos are based in the placement of pigmented foreign body material in the dermal layer of the skin using needles. This technique can produce a wide variety of adverse local effects (infections, appearance of neoplasms, reactivation of underlying dermatosis and allergic and toxic reactions) or even systemic effects. Many dyes may be used for this procedure, but it is red dye, the one that causes most of the clinical adverse effects. These red inks are classified as inorganic (mercury, cinnabar, cadmium, selenium, ferric hydrate) or organic (sandalwood, brazilwood) [1]. Many red tattoo reactions have been described, but it is the lichenoid pattern, the most frequent, followed by pseudolimphomatous, granulomatous, spongiotic or necrobiotic among others. No matter which kind of histopathological pattern is presented, they can produce intense itching and a great distress in the quality of life of the affected patients. Once the reaction has appeared, the common treatments include topical, intralesional or oral corticosteroids, antibiotic with anti-inflammatory effects, allopurinol and immunosuppresive agents. Nevertheless, there is no evidence about which is the most appropriate treatment. It would make sense that destructive methods, as surgery, would be the most effective, but depending on the location and the size of the tattoo, surgical excision is not always the best choice. Few reports just based on isolated cases have been published about laser treatment for the management of red ink reactions.