What is your diagnosis? Tinea in tattoo
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SUMMARY The pathogenesis of inoculation cutaneous tuberculosis requires a break in the skin, through minor abrasions or injury, allowing the entry of tubercle bacilli. We report a 33‐year‐old man who presented with erythematous papules over a tattoo on the right upper arm, 1 month after undergoing a tattoo procedure. Histology and cultures revealed infection with Mycobacterium tuberculosis . He was started on a 9‐month course of antituberculous medication and 3 months after initiation of the drugs all the papules had subsided. He has since completed the course of therapy and there has been no recurrence 1 year after treatment was started.
Cutaneous tuberculosis
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Thirty-one female patients with leprosy lesions starting over tattoo marks observed over a period of 16 years are reported. All the patients belonged to the Chhattisgarh State, which is highly endemic for leprosy. Most of the patients were in the third decade of life. All of them had ornamental tattooing done by roadside tattoo artists, who used unsterile needles for tattooing a large gathering one after another with the same needles. In all of them, the first lesion of leprosy started over a tattoo mark. Twenty-five cases had only single lesion of leprosy exclusively confined to tattoo marks. The duration between tattooing and appearance of first lesion in most of the cases varied from 10 to 20 years. Paucibacillary leprosy was the commonest type observed in 29 cases, while two had multibacillary leprosy. The diagnosis was confirmed by histopathology in all cases. The present report supports the hypothesis of transmission of leprosy in these cases through tattooing. To the best of our knowledge, such a large collection of leprosy cases subsequent to tattooing has not been reported so far.
Histopathology
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Decorative tattooing involves the introduction of exogenous pigments and/or dyes into the dermis to produce a permanent design. Practiced for thousands of years, it has gained tremendous popularity during the past 20 years, especially among the young. Tattoo-associated cutaneous complications have only been reported since the end of the 19th Century. With the increased prevalence of tattooed individuals, dermatologists have witnessed increasing numbers of patients presenting with complaints about their tattoos. Complications primarily include infections, hypersensitivity reaction to tattoo pigments, benign and sometimes malignant tumors arising on tattoos, and the localization of various dermatoses to tattoos.
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AIDS-Related Opportunistic Infections
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S ummary Subcutaneous zygomosis, caused by Saksenaea vasiformis developed In the forearm of a 25 year old male in the area of a tattoo performed seven years previously. The spectrum of disease caused by S. vasiformis can range from rapidly progressive disseminated infection in immunosuppressed persons, to disease of slow onset and limited spread where immune function is intact. Several species of zygomycetes can cause human disease. Tissue invasion is by broad mycelia which stain well with H & E. Species identification can only be achieved by inducing the isolate to produce sporangia, and in the case of S. vasiformis special techniques are necessary. Even so, long delays may be experienced before producing the typical long necked vase shaped sporangium of S. vasiformis. In the case described, treatment with amphotericin B was successful.
Zygomycosis
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