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Localized Chronic Fibrosing Vasculitis in a Tattoo: A Unique Adverse Tattoo Reaction

Deeken, Audrey BA*; Jefferson, Julie MD; Hawkinson, Dana MD; Fraga, Garth R. MD§

The American Journal of Dermatopathology: April 2014 - Volume 36 - Issue 4 - p e81–e83
doi: 10.1097/DAD.0b013e3182a27a99
Extraordinary Case Report

Abstract: Decorative tattoos are associated with a variety of adverse cutaneous reactions. We describe a unique fibrosing vasculitic reaction to red tattoo ink. The histopathology was similar to that in localized chronic fibrosing vasculitis (LCFV), but sharply limited to sites of red tattoo ink injection and associated with florid verrucoid epidermal hyperplasia. LCFV has been described in a broad variety of slowly progressive disorders with a firm consistency such as erythema elevatum diutinum, plasma cell granuloma, granuloma faciale, and IgG4-associated sclerosing diseases. It has been hypothesized that LCFV is the result of maladaptive immune reaction with failure to clear the causative antigen. To the best of our knowledge, this is the first case of LCFV associated with tattoo. We speculate on the implications our case holds for the pathogenesis of LCFV.

*University of Kansas School of Medicine, Kansas City, KS;

Division of Dermatology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS;

Division of Infectious Diseases, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS; and

§Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS.

Reprints: Garth R. Fraga, MD, Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, MS 3045, 3901 Rainbow Boulevard, Kansas City, KS 61660 (e-mail: gfraga@kumc.edu).

The authors declare no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.