Pitfalls and Recommendations in Cases of Laser Removal of Decorative Tattoos With Pigmented LesionsCase Report and Review of the Literature

• Autores: Laura Pohl, Kathrine Kaiser, Christian Raulin
• Localización: JAMA Dermatology, ISSN 2168-6068, Vol. 149, Nº. 9, 2013, págs. 1087-1089
• Idioma: inglés
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• Resumen

  • Importance Pigmented lesions in decorative tattoos cause diagnostic difficulties at a clinical and dermoscopic level. In cases of laser removal of tattoos, hidden suspicious nevi may be revealed gradually.

    Observations We describe the first case of a malignant melanoma that developed on a preexisting nevus within a tattoo during and between the phases of laser removal. The patient refused to undergo excision of the nevus until we made excision conditional for continued laser treatment.

    Conclusions and Relevance The English literature reports 16 cases of malignant melanoma developing in tattoos. Correlation between the placement of tattoos and the development of malignant melanoma remains unclear. Our case emphasizes the diagnostic problems of pigmented lesions within tattoos. For safety reasons, tattoos should never be placed on pigmented lesions; if they are, the tattoos should not undergo laser treatment. We suggest an excision before starting laser tattoo removal. Dermoscopic assessments on a regular basis during the period of tattoo removal are recommended.

    The number of decorative tattoos has been increasing, as has the demand for their removal by laser devices. Traumatic events, such as UV and ionizing radiation, mechanical trauma, persistent inflammatory reactions, and burning, have been discussed as cofactors for neoplasm.1,2 Only 16 cases in the English literature document malignant melanoma developing in tattoos.3- 5 We herein describe a malignant melanoma that developed on a nevus within a tattoo that had undergone removal by laser.