A patient consults the physician regarding her daughter's plans to get a tattoo. She wishes to be informed about the possible complications so that she can discuss the issue with her daughter. The mother asks for advice on how best to ensure that the procedure is done properly to minimize complications.
Which of the following infections is most commonly associated with the tattooing process?

Question

A patient consults the physician regarding her daughter's plans to get a tattoo.  She wishes to be informed about the possible complications so that she can discuss the issue with her daughter.  The mother asks for advice on how best to ensure that the procedure is done properly to minimize complications.
Which of the following infections is most commonly associated with the tattooing process?

Quizplus · Accepted Answer

11ec193a_9864_7310_853d_537ff9b9a9d0_MD0002_00 Ten to 15% of American adults have >1 tattoos. An electromagnetic coil causes a needle to oscillate, puncture the skin to 1-4 mm, and deposit pigmented ink that remains permanently entrapped in the superficial dermal fibroblasts. The inks are classified as cosmetics, but the pigments are considered color additives that require pre-marketing approval. However, the Food and Drug Administration does not have the authority to require pre-marketing safety data for inks. Therefore, many complications from inks are recognized retrospectively. Tattoo operators are usually licensed by local or state authorities and rarely have complications when using sterile equipment and excellent infection control practices. Tattoos not done under these circumstances can result in localized bacterial infections at the tattoo site due to Staphylococcus (most common), Mycobacterium chelonae, and Pseudomonas species. Any blood-borne pathogen (eg, hepatitis B and C) could be transmitted by tattooing under poorly controlled circumstances. Less common complications include disseminated infections with abscess formation, infectious endocarditis, and toxic shock syndrome. Noninfectious complications include hypersensitivity reactions due to inks containing mercury, chromium, cadmium, cobalt, and iron oxide. (Choice A) Hepatitis B has been associated with tattoos but is uncommon in licensed operators. Individuals planning to get a tattoo should make sure their hepatitis B vaccination status is up-to-date. (Choice B) Nontuberculous mycobacterial outbreaks have been associated with tattoos but are less common and usually present with reddish papules in the tattoo area. The likely source is contaminated tattoo ink. Skin biopsy is required and culture may take up to 6 weeks. (Choice D) Tetanus is a rare complication of tattoos. However, it is recommended that individuals planning to get a tattoo have up-to-date tetanus immunization status. (Choice E) Infection with Treponema pallidum has been reported as a rare complication of tattooing. Educational objective: The most common complications of tattoos are local skin infections from staphylococcal species and hypersensitivity reactions from metals in the ink. Disseminated infections and nontuberculous mycobacterial infections are less common. __________ References: Tattoo-associated nontuberculous mycobacterial skin infections, multiple states, 2011-2012. (http://www.ncbi.nlm.nih.gov/pubmed/22914227) Methicillin-resistant Staphylococcus aureus skin infections among tattoo recipients - Ohio, Kentucky, and Vermont, 2004-2005. (http://www.ncbi.nlm.nih.gov/pubmed/16791134) Infectious complications of tattoos. (http://www.ncbi.nlm.nih.gov/pubmed/8038318)

A Patient Consults the Physician Regarding Her Daughter's Plans to Get