ISSN: 0443-511
e-ISSN: 2448-5667
Herramientas del artículo
Envíe este artículo por correo electrónico (Inicie sesión)
Enviar un correo electrónico al autor/a (Inicie sesión)
Tamaño de fuente

Open Journal Systems

Hipersensibilidad a tinta roja de tatuaje, revisión a propósito de un caso / Hipersensibility to red tattoo ink, review of a case

Bárbara Isamara Rojo-Rodríguez, Blanca Elena Verazaluce-Rodríguez, Samira Viridiana Alcalá-Adame, José de Jesús Vargas-Montes, Yesica Guadalupe Barboza-García, Daniel Pascual-Jiménez



Introducción: la reacción de hipersensibilidad asociada a tinta de tatuaje y su manejo representan un reto diagnóstico y terapéutico, ya que no se ha realizado una guía de manejo homogénea, eficaz y segura. Por lo que se presenta una revisión con lo que se ha descrito en teorías fisiopatológicas, así como las propuestas terapéuticas y la respuesta encontrada en los casos relacionados que se han reportado.

Caso clínico: paciente hombre de 30 años que inicia con dermatosis localizada en extremidad superior derecha, unilateral, asimétrica, de aspecto monomorfo, constituida por mácula artificial, provocada por tinta roja (tatuaje), con desarrollo de lesiones de aspecto papular en trazo original, pruriginosa, tiempo de evolución referido de un mes. El hallazgo histopatológico corresponde a reacción de cuerpo extraño con respuesta parcial a esteroide tópico de baja potencia.

Conclusiones: según antecedentes en otros reportes y series de casos, incluyendo la experiencia con nuestro paciente, no existe una eficacia aplicable para la mayoría de los pacientes con el uso de inmunomodulares tópicos, ya que muestran mejoría completa hasta la eliminación del hapteno, ya sea de forma escicional o con láser. 



Introduction: The hypersensitivity reaction associated with tattoo ink and its management represent a growing challenge, despite having precedents in diagnostic and treatment experience in other reports or case series in recent decades, no one has been found homogeneous offer that is effective and safe. Therefore, a review is presented with what has been described in pathophysiological theories, as well as therapeutic proposals and the response found in related cases that have been reported to date.

Clinical case: 30-year-old male, with dermatosis located on the right upper extremity, affecting the inner side of the forearm and the outer side of the arm, unilateral, asymmetric, monomorphic in appearance, made up of an artificial macula, caused by red ink (tattoo), with development of papular like lesions in original trace, pruritic, referred evolution time of one month. Tattoo completion time of 5 and 2 years on the outer side of the right arm and inner side of the ipsilateral forearm, respectively.

Conclusions: According to antecedents in other reports and case series, including the experience of our patient, there is no proven efficacy with the use of topical immunomodulators, in turn, patients who shows complete improvement until the elimination of the allergen, either from excisional or laser.

Palabras clave

Hipersensibilidad; Tatuaje; Tratamiento / Hypersensibility; Tattoo; Treatment

Texto completo:



Sowden JM. Red tattoo reactions. X-ray microanalysis and patch-test studies. Br J Derm. 1991;124:576-80. doi: 10.1111/ j.1365-2133.1991.tb04954.x.

Serup J. How to Diagnose and Classify Tattoo Complications in the Clinic: A System of Distinctive Patterns. Curr Probl Dermatol. 2017;52:58-73. doi: 10.1159/000450780.

Imbernón-Moya A, Fernández-Cogolludo E, Gallego-Valdés MÁ. Three-Dimensional Strawberry Tattoo. Tatuaje de fresa en 3D. Actas Dermosifiliogr. 2017;108(10):950. doi: 10.1016/j. ad.2016.07.028.

Silvestre JF, González Villanueva I. Diagnostic Approach for Suspected Allergic Cutaneous Reaction to a Permanent Tattoo. J Investig Allergol Clin Immunol. 2019;29(6):405-413. doi: 10.18176/jiaci.0383.

Simunovic C, Shinohara MM. Complications of decorative tattoos: recognition and management. Am J Clin Dermatol. 2014;15(6):525-536. doi: 10.1007/s40257-014-0100-x.

Polimón I, Ortiz FJ, Comunión A, et al. Reacciones al color rojo de los tatuajes. Academia Española de Dermatología y Venereología. 2001;92:337-341.

Serup J. Diagnostic Tools for Doctors’ Evaluation of Tattoo Complications. Curr Probl Dermatol. 2017;52:42-57. doi: 10.1159/000450778.

Kluger N, Koljonen V. Tattoos, inks and cancer. Lancet Oncol. 2012;13(4):e161-8. doi: 10.1016/S1470-2045(11)70340-0.

Bäumler W. Absorption, distribution, metabolism and excretion of tattoo colorants and ingredients in mouse and man: the known and the unknown. Curr Probl Dermatol. 2015;48:176- 184. doi: 10.1159/000369222.

Baumler W, Eibler ET, Hohenleutner U, et al. Q-switch laser and tattoo pigments: first results of the chemical and photophysical analysis of 41 compounds. Lasers Surg Med. 2000; 26:13-21.

Engel E, Santarelli F, Vasold R, et al. Modern tattoos cause high concentrations of hazardous pigments in skin. Contact Dermatitis. 2008; 58:228-233. doi: 10.1111/j.1600-0536.2007.01301.x.

Kluger I, Hiller KA, Landthaler M, et al. Incidence of health problems associated with tattooed skin: a nationwide survey in German-speaking countries. Dermatology. 2010;221:43-50. doi: 10.1159/000292627.

Ferguson JE, Andrew SM, Jones CJ, et al. The q-switched neodymium: Yag laser and tattoos: a microscopic analysis of laser-tattoo interactions. Br J Dermatol. 1997;137:405-410.

Engel E, Spannberger A, Vasold R, et al. Photochemical cleavage of a tattoo pigment by UVB radiation or natural sunlight. J Dtsch Dermatol Ges. 2007;5:583-589. doi: 10.1111/j.1610-0387.2007.06333.x.

Fraser TR, Ross KE, Alexander U, et al. Current knowledge of the degradation products of tattoo pigments by sunlight, laser irradiation and metabolism: a systematic review. J Expo Sci Environ Epidemiol. 2022;32(3):343-355. doi: 10.1038/ s41370-021-00364-y.

Wollina U, Gruner M, Schönlebe J. Granulomatous tattoo reaction and erythema nodosum in a young woman: common cause or coincidence? J Cosmet Dermatol. 2008;7(2):84-8. doi: 10.1111/j.1473-2165.2008.00368.x.

Aberer W, Snauwaert JE, Render UM. Allergic reaction to pigments and metals. In: De Cuyper C and Perez-Cotapos ML, eds. Dermatologic complications with body art: tattoos, piercings and permanent make-up. Berlin-Heidelberg: Springer; 2010:61-89. doi: 10.1007/978-3-642-03292-9.

Høgsberg T, Thomsen BM, Serup J. Histopathology and immune histochemistry of red tattoo reactions. Interface dermatitis is the lead pathology, with increase in T-lymphocytes and Langerhans cells suggesting an allergic pathomechanism. Skin Res Technol. 2015;21(4):449-58. doi: 10.1111/srt.12213.

Kaur RR, Kirby W, Maibach H. Cutaneous allergic reactions to tattoo ink. J Cosmet Dermatol. 2009;8(4):295-300. doi: 10.1111/j.1473-2165.2009.00469.x.

Salinas L. Mecanismos de daño inmunológico. Revista Médica Clínica Las Condes. 2012;23(4):458-463. doi: 10.1016/ s0716-8640(12)70336-x.

Pichler WJ. Drug hypersensibility reactions: Pathomechanism and clinical symptoms. Med Clin N Am. 2010;94:645-64. doi: 10.1016/j.mcna.2010.04.003.

Serup J, Hutton-Carlsen K. Patch test study of 90 patients with tattoo reactions: negative outcome of allergy patch test to baseline batteries and culprit inks suggests allergen(s) are generated in the skin through haptenization. Contact Dermat. 2014;71:255-63. doi: 10.1111/cod.12271.

De Cuyper C. Tattoo allergy. Can we identify the allergen? Presse Med. 2020;49(4):104047. doi: 10.1016/j.lpm.2020.104047.

Hoefakker S, Caubo M, van ‘t Erve EH, et al. In vivo cytokine profiles in allergic and irritant contact dermatitis. Contact Dermatitis. 1995;33:258-266. doi: 10.1111/j.1600-0536.1995. tb00478.x.

Kyanko ME, Pontasch MJ, Brodell RT. Red tattoo reactions: treatment with the carbon dioxide laser. J Dermatol Surg Oncol. 1989;15(6):652-6. doi: 10.1111/j.1524-4725.1989.tb03604.x.

Sowden JM, Cartwright PH, Smith AG, et al. Sarcoidosis presenting with a granulomatous reaction confined to red tattoos. Clin Exp Dermatol. 1992;17(6):446-8. doi: 10.1111/j.1365-2230. 1992.tb00257.x.

Antony FC, Harland CC. Red ink tattoo reactions: successful treatment with the Q-switched 532 nm Nd:YAG laser. Br J Dermatol. 2003;149(1):94-8. doi: 10.1046/j.1365-2133.2003.05342.x.

De Argila D, Chaves A, Moreno JC. Erbium: Yag laser therapy of lichenoid red tattoo reaction. J Eur Acad Dermatol Venereol. 2004;18(3):332-3. doi: 10.1111/j.1468-3083.2004.00936.x.

Jones B, Oh C, Egan CA. Spontaneous resolution of a delayed granulomatous reaction to cosmetic tattoo. Int J Dermatol. 2008;47(1):59-60. doi: 10.1111/j.1365-4632.2007.03386.x.

Kluger N, Mathelier-Fusade P, Moguelet P. Scleroderma-like reaction restricted to the red parts of a tattoo. Acta Derm Venereol. 2009;89:95-6. doi: 10.2340/00015555-0542.

Tammaro A, Tuchinda P, Persechino S, et al. Contact allergic dermatitis to gold in a tattoo: a case report. Int J Immunopathol Pharmacol. 2011;24(4):1111-3. doi: 10.1177/039463201102400432.

Garcovich S, Carbone T, Avitabile S, et al. Lichenoid red tattoo reaction: histological and immunological perspectives. Eur J Dermatol. 2012;22(1):93-6. doi: 10.1684/ejd.2011.1558.

Sweeney SA, Hicks LD, Ranallo N, et al. Perforating granulomatous dermatitis reaction to exogenous tattoo pigment: a case report and review of the literature. Am J Dermatopathol. 2013;35(7):754-6. doi: 10.1097/DAD.0b013e318209f117.

Ruiz-Rivero J, Barchino-Ortiz L. Reacción granulomatosa de cuerpo extraño a pigmento rojo de tatuaje [Foreign body granulomatous reaction to red tattoo pigment]. Med Clin (Barc). 2014;143(11):520. doi: 10.1016/j.medcli.2014.07.026.

Psaltis NM, Gardner RG, Denton WJ. Systemic sarcoidosis and red dye granulomatous tattoo inflammation after influenza vaccination: a case report and review of literature. Ocul Immunol Inflamm. 2014;22(4):314-21. doi: 10.3109/09273948.2014.891041.

Gamba CS, Lambert-Smith F, Wisell J, et al. Tattoo reactions in an HIV patient: Autoeczematization and progressive allergic reaction to red ink after antiretroviral therapy initiation. JAAD Case Rep. 2015;1(6):395-8. doi: 10.1016/j.jdcr.2015.09.007.

Martín-Callizo C, Marcoval J, Penín RM. Granulomatous Reactions to Red Tattoo Pigments: A Description of 5 Cases. Actas Dermosifiliogr. 2015;106(7):588-90. doi: 10.1016/j. ad.2014.12.010.

Jaehn T, Kaiser A, Grüneis C, et al. Pseudolymphomatöse Fremdkörperreaktion nach Tätowierung [Pseudolymphatic allergic immune reaction after tattooing]. Handchir Mikrochir Plast Chir. 2014;46(6):379-82. doi: 10.1055/s-0034-1395559.

Haber R, Farid S. Réaction granulomateuse confinée à l’encre rouge de tatouage [Granulomatous tattoo reaction confined to red pigment]. Ann Dermatol Venereol. 2016;143(1):79-80. doi: 10.1016/j.annder.2015.09.001.

Incel-Uysal P, Gurel MS, Behzatoglu K. A Tattoo-Associated Complication: Foreign Body Granulomatous Reaction. Am J Dermatopathol. 2016;38(12):936-937. doi: 10.1097/ DAD.0000000000000570.

Pérez-López I, Blasco-Morente G, Martínez-López A, et al. Tatuaje en 3 dimensiones, granuloma por cuerpo extrano. Med Clin (Barc). 2016. Disponible en: medcli.2016.05.039.

Wambier CG, Cappel MA, Wambier SPF. Tratamiento de la reacción a la tinta roja del tatuaje con triamcinolona intralesional. An Bras Dermatol. 2017;92(5):748-750. doi: 10.1590/ abd1806-4841.20176678.

Imbernón-Moya A, Fernández-Cogolludo E, Gallego-Váldes MA. Tatuaje de fresa en 3D. Actas Dermosifiliogr. 2017. doi: 10.1016/

Arshdeep, Chougule A, De D, Handa S. Granuloma Annulare-Like Granulomatous Reaction to Red Tattoo Pigment. J Cutan Med Surg. 2018;22(6):618-620. doi: 10.1177/1203475418771614.

González-Villanueva I, Álvarez-Chinchilla P, Silvestre JF. Allergic reaction to 3 tattoo inks containing Pigment Yellow 65. Contact Dermatitis. 2018;79(2):107-108. doi: 10.1111/cod.13004.

Kluger N, Godenèche J, Vermeulen C. Granuloma annulare within the red dye of a tattoo. J Dermatol. 2012;39(2):191-3. doi: 10.1111/j.1346-8138.2010.01195.x.

Enlaces refback

  • No hay ningún enlace refback.