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TREATMENT APPROACH OF TATTOO - HEAVY METAL'S DYE INDUCING ACUTE ULCERATIVE SKIN LESION
Dr. Muhi N. Salman1
1 Dep. Toxicology, Baghdad college of medical sciences
Email address: [email protected]
Tocitethis article: DR.Muhi .N Salman-TreatmentapproachofTattoo - heavy metal's dye inducingacute ulcerative skinlesion //News of scientific achievements. Medicine and pharmacy. - 2019. - №1. - C. 30-32. DOI: 10.36616/2713-1718-2019-1-30-32 URL: https://vestind.ru/journals/medicine/releases/2019-1/articles?pdfView&page=30
Received: November 29, 2019; Accepted: December 2, 2019; Published: December 28, 2019
Abstract: The occurrence of tattoos of associated adverse skin reactions markedly increased in the last two decades. Aims; to apply new treatment approach for tattoos -heavy metal's dye inducing skin ulcerative lesion. Materials and Methods; combination treatment of systemic antibiotic - cortisone, a topical hydrogel dressing with adjuvant laser therapy was to achieve healing of ulcerative -crater skin lesion. Results; recovery of complete healing a deep ulcerative skin lesion was successful. Conclusion; Tattoos heavy metal - dye can induce severe skin reactions starting from simple inflammatory reaction to ends up to break down of skin and persistent skin lesion.
Keywords: Magnetic resonance imaging (MRI scan), methicillin -resistant staphylococcus aureus (MRSA), para-phenylenediamine (PPD),
1. Introduction
Decorative tattooing is direct reaction response to the piercing of the skin with needles impregnated with pigment dyes prepared from metal salts. There may be transient redness and swelling of the area that disappears within 2-3 weeks. It is an expected side effect of the tattooing process. describes the appearance of new lesions of an existing skin disease within a cutaneous injury. Reactions that may occur include acute inflammatory include acute inflammatory reactions, eczematous hypersensitivity reactions, photo-aggravated reactions, granulomatous. Red tattoo pigments cause the most reactions, particularly those made from mercury sulfide (cinnabar). The components of tattoo ink are difficult to determine and undergo changes with time, without regulations for tattoo inks or color additives, which contain inorganic pigments and carbon black, and/or organic pigments from various chemical classes Contact dermatitis has also been reported in people with Henna tattoos are painted onto the skin with an artist's brush resulting in a brownish stain 2,3]. Henna itself should be safe, but the dye is often mixed with paraphenylenediamine (PPD), a chemical substance that is well known for causing allergic reactions in people sensitive to it (4,5).
2. Case reports
A 29 year-old female patient was admitted
to outpatient of private burns therapy center suffering from itching, painful redness, swelling and skin persistent ulcerative crater on her upper left hand of orange to red decorative tattoos near the shoulder joint. The patient developed this reaction slowly, in the course of 2 weeks to 1 months after the patient underwent Magnetic resonance imaging (MRI scan) due to car accident . Swap was taken from the lesion for bacterial culture ,demonstrated methicillin -resistant staphylococcus aureus (MRSA).The healing ulcerative lesion was poorly respond to traditional prescribed topical hydrocortisone -antibiotic applications figure 1.
3. Methods and Materials; Clinical treatment's approach;
3.1 non pharmacotherapy (mesotherapy); clearance of tattoo's area surrounding lesion of skin ulcer 0.5 - 1cm by 1-2 treatments with laser therapy at (532nm) frequency dedicated for orange to red tattoo's pigment in order to stop leakage deposit of current tattoos to margin of ulcerative lesion [12].
3.2 pharmacotherapy; methyl prednisolone 40 mg twice for 1 week slowly i.v was given to control accompanied inflammatory respones piperacillin /tazobactum, antibiotic combination of penicillin for skin and bone structure infection
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Figure (1). (a) before MRI EXPOSURE (b)after MRI EXPOSURE
,6 gm i.v infusion was given as 2gm in 200ml normal saline 0.9% drip within 9 days. Purilon gel-coloplast, gentle hydrogel consisting of natural ingredients promotes wound healing (burns &ulcer) by effective debridement is applied inside the skin ulcer's crater each other day over 1 weeks. Comfeel plus-coloplast, excellent support of wound closure, transparent dressing as bacterial prophylactic barrier, waterproof top film and easy wound healing inspection for 2weeks days.
4.Results; The healing process was appeared gradually as granulation tissue step of skin recovery on the fifth day and end up intact complete skin healing status at the end of the third week.
5. Discussion& Conclusions
Acute and chronic inflammatory reactions is a frequent side effect of the tattooing process, due to physical injury to tissue and the injection of pigment into the skin Erythema and swelling appears, that disappears within 2-3 weeks.
Delayed reactions, most often immunological contact dermatitis, occur several weeks or years after the tattoo, which appear as foreign body reactions to inserted pigment. In most cases red tattoo pigments (mercury) as well as green, blue (cobalt) or purple (manganese) are associated with granulomatous reactions [1]. Clinically were diagnosis as acute and chronic inflammatory reactions in form as pyoderma, impetigo, cellulitis, as pyoderma, impetigo, cellulitis, as pyoderma, impetigo, cellulitis, herpessimplex virus, papilloma virus (warts), poxvirus (molluscum) and systemic infection with hepatitis B, C and HIV [7-11]. Several pathogenic bacteria were isolated from contaminate tattoo ink [6,13,14]. Magnetic resonance imaging (MRI scan) produces a magnetic field that has been reported to induce an electric current within tattoo ink containing iron oxide. Both tattoos and cosmetics may contain particles of iron oxides or other metals that, by interacting with the magnetic field, can cause sensations of heat, burns, swelling or local irritation during an MRI examination [15].
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© DR.MUHI .S SALMAS. 2019
