Lichenoid red tattoo reaction: Histological and immunological perspectives

Simone Garcovich, Teresa Carbone, Simona Avitabile, Francesca Nasorri, Nadia Fucci, Andrea Cavani

Research output: Contribution to journalArticlepeer-review


As tattooing practices increase, delayed-type inflammatory reactions represent an uncommon adverse event to tattoo pigments. Different reaction patterns, such as eczematous, lichenoid, granulomatous and pseudolymphomatous reactions, have been previously reported, especially in association with metals contained in red tattoo pigments. We report a lichenoid papular reaction to an organic red tattoo ink, characterized by an intense mononuclear infiltrate dominated by CD8 + T cells and CD56 + lymphocytes and distributed in the superficial dermis around the red pigment and in the epidermis. Cytofluorimetric analysis of the lesional skin infiltrate confirmed the high frequency of cytotoxic CD8 + T cells and CD56 +CD16 - lymphocytes, most of which release type 1 cytokines. Chemical analysis of the red tattoo pigment confirmed its organic nature and the presence of intermediate reactive compounds. The lichenoid tissue reaction to red organic tattoo pigment showed the prototypical features of a cytotoxic inflammatory response to foreign substances (xenobiotics). The chemically unstable and reactive nature of modern tattoo pigments has to be taken into account by the clinician as well by the tattoo recipients.

Original languageEnglish
Pages (from-to)93-96
Number of pages4
JournalEuropean Journal of Dermatology
Issue number1
Publication statusPublished - Jan 2012


  • Immunophenotyping
  • Lichen
  • Pigment
  • Red ink tattoo reaction
  • Tattoo

ASJC Scopus subject areas

  • Dermatology


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