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Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review

The increasing popularity of tattooing has paralleled an increase in associated cutaneous reactions. Red ink is notorious for eliciting cutaneous reactions. A common reaction is pseudoepitheliomatous hyperplasia (PEH), which is a benign condition closely simulating squamous cell carcinoma (SCC). Dif...

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Autores principales: Rahbarinejad, Yasmina, Guio-Aguilar, Pedro, Vu, Anh Ngoc, Lo, Michael, McTigue, Christine, Nirenberg, Alex, Rozen, Warren M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056737/
https://www.ncbi.nlm.nih.gov/pubmed/36983424
http://dx.doi.org/10.3390/jcm12062424
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author Rahbarinejad, Yasmina
Guio-Aguilar, Pedro
Vu, Anh Ngoc
Lo, Michael
McTigue, Christine
Nirenberg, Alex
Rozen, Warren M.
author_facet Rahbarinejad, Yasmina
Guio-Aguilar, Pedro
Vu, Anh Ngoc
Lo, Michael
McTigue, Christine
Nirenberg, Alex
Rozen, Warren M.
author_sort Rahbarinejad, Yasmina
collection PubMed
description The increasing popularity of tattooing has paralleled an increase in associated cutaneous reactions. Red ink is notorious for eliciting cutaneous reactions. A common reaction is pseudoepitheliomatous hyperplasia (PEH), which is a benign condition closely simulating squamous cell carcinoma (SCC). Differentiating PEH from SCC is challenging for pathologists and clinicians alike. The exact pathogenesis of these lesions secondary to red ink is not known, and there are no sources outlining diagnostic and treatment options and their efficacy. We present four study cases with different pathologies associated to red ink tattoos including lichenoid reaction, granulomatous reaction, PEH, and an SCC. Additionally, an extensive review of 63 articles was performed to investigate pathogenesis, diagnostic approaches, and treatment options. Hypotheses surrounding pathogenesis include but are not limited to the carcinogenic components of pigments, their reaction with UV and the traumatic process of tattooing. Pathogenesis seems to be multifactorial. Full-thickness biopsies with follow-up is the recommended diagnostic approach. There is no evidence of a single universally successful treatment for PEH. Low-dose steroids are usually tried following a step up in lack of clinical response. For SCC lesions, full surgical excision is widely used. A focus on clinicians’ awareness of adverse reactions is key for prevention. Regulation of the unmonitored tattoo industry remains an ongoing problem.
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spelling pubmed-100567372023-03-30 Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review Rahbarinejad, Yasmina Guio-Aguilar, Pedro Vu, Anh Ngoc Lo, Michael McTigue, Christine Nirenberg, Alex Rozen, Warren M. J Clin Med Review The increasing popularity of tattooing has paralleled an increase in associated cutaneous reactions. Red ink is notorious for eliciting cutaneous reactions. A common reaction is pseudoepitheliomatous hyperplasia (PEH), which is a benign condition closely simulating squamous cell carcinoma (SCC). Differentiating PEH from SCC is challenging for pathologists and clinicians alike. The exact pathogenesis of these lesions secondary to red ink is not known, and there are no sources outlining diagnostic and treatment options and their efficacy. We present four study cases with different pathologies associated to red ink tattoos including lichenoid reaction, granulomatous reaction, PEH, and an SCC. Additionally, an extensive review of 63 articles was performed to investigate pathogenesis, diagnostic approaches, and treatment options. Hypotheses surrounding pathogenesis include but are not limited to the carcinogenic components of pigments, their reaction with UV and the traumatic process of tattooing. Pathogenesis seems to be multifactorial. Full-thickness biopsies with follow-up is the recommended diagnostic approach. There is no evidence of a single universally successful treatment for PEH. Low-dose steroids are usually tried following a step up in lack of clinical response. For SCC lesions, full surgical excision is widely used. A focus on clinicians’ awareness of adverse reactions is key for prevention. Regulation of the unmonitored tattoo industry remains an ongoing problem. MDPI 2023-03-21 /pmc/articles/PMC10056737/ /pubmed/36983424 http://dx.doi.org/10.3390/jcm12062424 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rahbarinejad, Yasmina
Guio-Aguilar, Pedro
Vu, Anh Ngoc
Lo, Michael
McTigue, Christine
Nirenberg, Alex
Rozen, Warren M.
Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title_full Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title_fullStr Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title_full_unstemmed Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title_short Pathogenesis, Diagnosis and Management of Squamous Cell Carcinoma and Pseudoepithelial Hyperplasia Secondary to Red Ink Tattoo: A Case Series and Review
title_sort pathogenesis, diagnosis and management of squamous cell carcinoma and pseudoepithelial hyperplasia secondary to red ink tattoo: a case series and review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056737/
https://www.ncbi.nlm.nih.gov/pubmed/36983424
http://dx.doi.org/10.3390/jcm12062424
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