Summary: A new case study reveals a woman experienced ongoing chronic pain after receiving a tattoo while her immune system was compromised. While the cause of her condition isn’t known, doctors believe the pain is likely linked to the tattooing process, which may have been compounded by her compromised immune system.
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.
Source: Caroline White – BMJ
Publisher: Organized by NeuroscienceNews.com.
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Unusual association of diseases/symptoms: Unusual complication of a tattoo in an immunosuppressed patient” by William Thomas Wilson, Mannix O’Boyle, William J Leach in BMJ Case Reports. Published June 18 2018
Unusual association of diseases/symptoms: Unusual complication of a tattoo in an immunosuppressed patient
Tattooing for decorative body art is becoming more popular and, as a result, so are tattoo-related complications. Patients are unlikely to discuss tattoos with medical professionals, even though these might be relevant. Long-term immunosuppressed patients are often young adults who may wish to consider tattooing. It is well recognised that immunosuppressed patients are at increased risk of infection including cutaneous mycobacterial infections. They therefore represent a group that is at a potentially higher risk of tattoo-related complications and warrant special consideration.
We present the first documented case of inflammatory myopathy as a complication following tattooing in an immunosuppressed individual. This unusual case presented as distal thigh and medial knee pain and it was only after some time that a link to the tattoo was made. This serves as a reminder to consider tattoo-related complications in the differential diagnosis of unusual atraumatic musculoskeletal pain, especially in immunosuppressed individuals.