BMJ: Getting a tattoo may have some unexpected complications if your immune system isn’t up to scratch, warn doctors in the journalBMJ Case Reports. The
warning comes after they treated a woman for chronic pain in her left
hip, knee and thigh some months after she had been tattooed. She had been taking drugs to dampen down her immune system for several years after receiving a double lung transplant in 2009.
Her right leg had been tattooed several years earlier, with no ill effects, and she decided to have another on her left thigh.
Immediately
after this one, she experienced mild skin irritation, which is not
unusual, explain the authors. But 9 days later, she developed pain in
her left knee and thigh. Her symptoms were so severe that she needed
strong painkillers.
Although
her symptoms eased, they were still troubling her 10 months later. So
she was referred to a rheumatology clinic, where she was tested for
various conditions, the results of which all came back negative.
But
a biopsy of her thigh muscle revealed that she had inflammatory
myopathy–chronic muscle inflammation. This is often accompanied by
muscle weakness and pain.
In
many cases, the cause of this isn’t known, and it may arise
spontaneously. But in this case the doctors believe that it is likely to
have been linked to the tattoo process itself, the effects of which may
have been compounded by a compromised immune system.
“While
we acknowledge that there is no evidence to definitely prove the
causative effect, the timing of onset and the location of the symptoms
correlated well with the tattoo application and there were no other
identifiable factors to cause the pathology,” they write.
The
woman was given physiotherapy to strengthen her thigh muscles, and one
year after the start of her symptoms, she began to improve. And after
three years, she was pain free.
How
the tattooing process might have contributed to the woman’s symptoms
isn’t clear. But it is well known that the type of ink or colourant used
in tattoos can cause a reaction, say the authors, who point out that
tattooing has been associated with various complications, ranging from
mild skin irritation to systemic infection.
“The
tattoo industry has no regulated or professional body to enhance
standards across the UK,” highlight the authors. “In this case, the
tattoo application by an unregulated parlour, combined with the
patient’s immune suppression could have resulted in the adverse
reaction,” they suggest.
Getting
a tattoo is becoming increasingly popular, they add, so patients with
compromised immune systems should be aware of the potential risks
associated with this type of decorative body art.
Case report: Unusual complication of a tattoo in an immunosuppressed patient doi: 10.1136/bcr-2018-224968
Journal: BMJ Case Reports